Emmanuel Ayawvi

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12507 Issued in GA

Practice address

1310 Club Dr
Vallejo, CA 94592-1187

Phone

(707) 638-5809

NPI assigned

Mar 10, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Emory Medical Care Foundation Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1063452381
  Medicare reassignment Care Compare group
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment Care Compare group
• Emory Medical Care Foundation

  • Emergency Medicine Physician
  • Atlanta, GA
  • NPI 1982860490
  NPD
• Emory Medical Care Foundation Inc

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1225294739
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grady Memorial Hospital Corporation

  dba Grady Health Systems

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1548918485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 CLUB DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945921187",
            "telephone_number": "707-638-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 CLUB DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945921187",
            "telephone_number": "707-638-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYAWVI",
        "first_name": "EMMANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-10",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hisham Awadalla, PHARMD
• Axelrode Orthodontics Vallejo California
• Daniel Ayala-Ayala
• Valeria Quinones Ayala, RPH
• Erika Del Refugio Ayar, MD
• Sabah Ayubyar
• Susan Ayyad
• Diana Azeltine, REGISTERED NURSE
• Caitlin Elise Azemar, MS, DO
• Alicia Baatrup

• Physician Assistant in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.