Active NPI
Ebtisam Mohammed Alumin Osman, M.D
- Neurology Physician
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 84013
- Practice address
- 12 Executive Park Dr NE
Atlanta, GA 30329-2206 - Phone
- (404) 727-1452
- NPI assigned
- May 15, 2015
- Last updated
- Oct 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neurology Physician | 2084N0400X | 84013 | GA | Primary |
Addresses
Primary practice location
12 Executive Park Dr NE
Atlanta, GA 30329-2206
Mailing address
780 Canton Rd NE Ste 400
Marietta, GA 30060-7298
Phone (770) 422-3602
Other practice location 1
780 Canton Rd NE Ste 400
Marietta, GA 30060-7298
Phone (770) 422-3602
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ealuminosman376528@directwellstar.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1510 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 845-3905
1514 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 880-7222
2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (770) 732-4022
2540 Windy Hill Rd
Marietta, GA 30067-8605
Phone (770) 644-1570
2540 Windy Hill Serd
Marietta, GA 30067-8605
Phone (770) 644-1274
2550 Windy Hill Rd SE
Suite 220
Marietta, GA 30067-8605
Phone (404) 321-9900
3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2912
3747 Roswell Rd
Marietta, GA 30062-6227
3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
601 S 8TH St
Griffin, GA 30224-4213
Phone (770) 228-2721
625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004
677 Church Nest
Marietta, GA 30060-1101
677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585
780 Canton Nerd
Suite 400
Marietta, GA 30060-7298
Phone (770) 422-3602
780 Canton Rd NE
Marietta, GA 30060-7298
Phone (770) 422-3602
Hospital & facility affiliations
- Wellstar Kennestone Regional Medical Center
- Wellstar Cobb Medical Center
- Wellstar North Fulton Medical Center
- Wellstar Paulding Medical Center
- Wellstar Windy Hill Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Cardiovascular Medicine, LLC | Past | Accepting new patients |
Locations
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
780 Canton Rd NE
Ste 400
Marietta, GA 30060
Phone (770) 422-3602
780 Canton Rd NE
Ste 410
Marietta, GA 30060
Phone (678) 370-0370
805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616
Interoperability endpoints
- ealuminosman376528@directwellstar.org
Organizations & group practices 3
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.
-
dba WellStar Family Medicine ACW
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
-
- Cardiovascular Disease Physician
- Marietta, GA
- NPI 1457320319
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Wellstar Cobb Hospital
- General Acute Care Hospital
- Austell, GA
- NPI 1467420448
-
dba Wellstar Kennestone Hospital
- General Acute Care Hospital
- Marietta, GA
- NPI 1649248626
-
dba Wellstar Windy Hill Hospital
- Long Term Care Hospital
- Marietta, GA
- NPI 1700853041
Long-term care hospital
-
dba Wellstar Paulding Hospital
- General Acute Care Hospital
- Hiram, GA
- NPI 1457329435
-
dba WellStar North Fulton Hospital
- General Acute Care Hospital
- Roswell, GA
- NPI 1750312997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601510400000",
"number": "1659759207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "780 CANTON RD NE STE 400",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300607298",
"telephone_number": "770-422-3602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 EXECUTIVE PARK DR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292206",
"telephone_number": "404-727-1452"
}
],
"practiceLocations": [
{
"address_1": "780 Canton Rd NE Ste 400",
"address_purpose": "LOCATION",
"city": "Marietta",
"state": "GA",
"postal_code": "300607298",
"country_code": "US",
"telephone_number": "770-422-3602",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALUMIN OSMAN",
"first_name": "EBTISAM",
"middle_name": "MOHAMMED",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-15",
"last_updated": "2020-10-01",
"certification_date": "2020-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "GA",
"license": "84013",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ealuminosman376528@directwellstar.org",
"affiliation": "N",
"address_1": "780 Canton Rd NE Ste 400",
"city": "Marietta",
"state": "GA",
"country_code": "US",
"postal_code": "300607298",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.