NPIMap

Individual provider Active NPI

Abdulwahab M Ewaz

  • Anatomic Pathology & Clinical Pathology Physician
  • Atlanta, GA
National Provider Identifier
1669737920
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
76070 Issued in GA
Practice address
1364 Clifton Rd NE RM N251
Atlanta, GA 30322-1059
Phone
(404) 727-3216
NPI assigned
Jul 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 76070 GA
Anatomic Pathology Physician 207ZP0101X 76070 GA
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 76070 GA Primary

Addresses

Primary practice location

1364 Clifton Rd NE RM N251
Atlanta, GA 30322-1059

Mailing address

651 Ilalo St
Honolulu, HI 96813-5525

Other practice location 1

11038 Lake City Way NE Apt 411
Seattle, WA 98125
Phone (808) 358-6835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190328000754 GA Practitioner - Pathology 9739429838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76070GAMDCytopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Pathology PC Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2023 Accepting new patients
The Emory Clinic Inc CurrentSince Sep 1, 2018 Accepting new patients

Locations

6100 Waterford District Dr
Ste 450
Miami, FL 33126

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

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

Interoperability endpoints

  • Direct secure messaging: aewaz38538@direct.emory.org
  • Direct secure messaging: aewaz2949919@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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 6

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1669737920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 ILALO ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE RM N251",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-727-3216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11038 Lake City Way NE Apt 411",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98125",
            "country_code": "US",
            "telephone_number": "808-358-6835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EWAZ",
        "first_name": "ABDULWAHAB",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "GA",
            "license": "76070",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "GA",
            "license": "76070",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "76070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.