Individual provider Active NPI

Fredrick Ntumy, M.D.

  • Pediatric Anesthesiology Physician
  • Marietta, GA
National Provider Identifier
1720494826
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
90709 Issued in GA
Practice address
2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone
(470) 644-1274
Fax
(470) 644-1119
NPI assigned
Jul 9, 2014
Last updated
May 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036153364 IL
Anesthesiology Physician 207L00000X 90709 GA
Pediatric Anesthesiology Physician 207LP3000X 036153364 IL
Pediatric Anesthesiology Physician 207LP3000X 90709 GA Primary

Addresses

Primary practice location

2540 Windy Hill Rd SE
Marietta, GA 30067-8605

Mailing address

777 Hemlock St # 159
Macon, GA 31201-2102
Phone (470) 607-5806

Other practice location 1

550 Peachtree St NE
Atlanta, GA 30308-2212
Phone (470) 831-7840

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fntumy536972@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211210001580 GA Practitioner - AnesthesiologyPractitioner - Pediatric Medicine 2264658780 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pediatric Medicine
Education
Rush Medical College of Rush University, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 702-1806

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036153364ILMDAnesthesiology Physician
90709GAMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jan 1, 2024 Accepting new patients
American Anesthesiology Associates of Georgia, LLC Anesthesiology CurrentSince Sep 17, 2022 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
The Board of Trustees of the University of Illinois Anesthesiology PastSince Jan 19, 2020 Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

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

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

777 Hemlock St
#159
Macon, GA 31201

888 Pine St
Macon, GA 31201
Phone (478) 751-0527

2540 Windy Hill Rd SE
Marietta, GA 30067
Phone (470) 644-1274

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

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 2

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": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1720494826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST # 159",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "470-607-5806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 WINDY HILL RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678605",
            "telephone_number": "470-644-1274",
            "fax_number": "470-644-1119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Peachtree St NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303082212",
            "country_code": "US",
            "telephone_number": "470-831-7840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NTUMY",
        "first_name": "FREDRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-09",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036153364",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "90709",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "IL",
            "license": "036153364",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "GA",
            "license": "90709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fntumy536972@directwellstar.org",
            "affiliation": "N",
            "address_1": "2540 Windy Hill Rd SE",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300678605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.