Individual provider Active NPI

Amy O'Leary, RD

  • Medical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1659857688
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
100 Woodruff Cir NE
Atlanta, GA 30322-0005
Phone
(703) 585-5787
NPI assigned
Jul 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DX4446 MD
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

100 Woodruff Cir NE
Atlanta, GA 30322-0005

Mailing address

100 Woodruff Cir NE
Atlanta, GA 30322-1020

Other practice location 1

600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 955-1637

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240422002113 GA Practitioner - Physician Assistant 1153760285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Virginia School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

11800 Northfall LN
Suite 1406
Alpharetta, GA 30009-7976
Phone (877) 448-3627

Hospital & facility affiliations

  • Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
DX4446MDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants, LLC CurrentSince Apr 4, 2004 Accepting new patients
Metro Infectious Disease Consultants LLC CurrentSince Apr 4, 2004 Accepting new patients
Metro Infectious Disease Consultants, LLC Past Accepting new patients

Locations

11800 Northfall Ln
Ste 1406
Alpharetta, GA 30009
Phone (678) 413-1360

2665 N Decatur Rd
Ste 330
Decatur, GA 30033
Phone (404) 297-9755

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

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 and National Provider Directory roles.

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": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1659857688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WOODRUFF CIR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODRUFF CIR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303220005",
            "telephone_number": "703-585-5787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870005",
            "country_code": "US",
            "telephone_number": "410-955-1637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'LEARY",
        "first_name": "AMY",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX4446",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.