Individual provider Active NPI

Eman Y Ismael

  • Emergency Medicine Physician
  • Marietta, GA
National Provider Identifier
1629657119
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
99211 Issued in GA
Practice address
677 Church St NE
Marietta, GA 30060-1101
Phone
(770) 793-5000
NPI assigned
Apr 3, 2021
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X
Emergency Medicine Physician 207P00000X 99211 GA Primary

Addresses

Primary practice location

677 Church St NE
Marietta, GA 30060-1101

Mailing address

1178 Leybourne CV
Lawrenceville, GA 30045-3572
Phone (303) 564-4420

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815001897 GA Practitioner - Emergency Medicine 3375944358 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walker Lake Emergency Group PCGroup PAC ID 0840531919, 31 clinicians
Fort Oglethorpe Emergency Physicians Group LLCGroup PAC ID 8527323633, 5 clinicians

Practice addresses (Care Compare)

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

901 18TH St E
Tifton, GA 31794-3648
Phone (229) 382-7120

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
99211GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peach State Emergency Physicians LLC Emergency Medicine CurrentSince Feb 1, 2025 Accepting new patients
Fort Oglethorpe Emergency Physicians Group LLC Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Phoebe Sumter Medical Center, Inc CurrentSince Oct 19, 2024 Accepting new patients
Walker Lake Emergency Group, PC Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients
Phoebe Sumter Medical Center, Inc. General Acute Care Hospital CurrentSince Oct 19, 2024 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Coweta Emergency Group LLC Emergency Medicine Past Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

2855 Old Highway 5
Blue Ridge, GA 30513
Phone (706) 632-4263

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

2160 Fountain Dr
Snellville, GA 30078
Phone (770) 982-1111

2460 Washington Rd
Thomson, GA 30824
Phone (706) 595-1411

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

Organizations & group practices 7

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1629657119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1178 LEYBOURNE CV",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453572",
            "telephone_number": "303-564-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101",
            "telephone_number": "770-793-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAEL",
        "first_name": "EMAN",
        "middle_name": "Y",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-03",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "99211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.