Individual provider Active NPI

Alysha S Jaffer, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Decatur, GA
National Provider Identifier
1760677322
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
005146 Issued in GA
Practice address
2536 Lawrenceville Hwy
Decatur, GA 30033-3227
Phone
(770) 934-6832
Fax
(770) 934-6337
NPI assigned
Sep 7, 2007
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 005146 GA Primary
Emergency Medicine Physician 207P00000X 001615 GA
Emergency Medicine Physician 207P00000X 1615 GA

Addresses

Primary practice location

2536 Lawrenceville Hwy
Decatur, GA 30033-3227

Mailing address

755 Walther Rd
Lawrenceville, GA 30046-8725
Phone (770) 290-8087

Other identifiers 1

IdentifierTypeStateIssuer
225403045 A & BMedicaidGA

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
I20071015000297 GA Practitioner - Physician Assistant 4688760192 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Choice Urgent Care, LLCGroup PAC ID 1951690213, 19 clinicians
Northside Urgent Care Holding LLCGroup PAC ID 4587984695, 77 clinicians

Practice addresses (Care Compare)

2690 Hamilton Mill Rd
Suite 100
Buford, GA 30519-4193
Phone (470) 326-7300

4215 Pleasant Hill Rd
Duluth, GA 30096-6332
Phone (470) 451-0655

5910 Suwanee Dam Rd
Suite 100
Sugar Hill, GA 30518-5648
Phone (470) 326-7600

665 Duluth Hwy
Lawrenceville, GA 30046-3328
Phone (470) 451-0650

81 Northside Dawson Dr
Suite 100a
Dawsonville, GA 30534-7166
Phone (706) 216-6000

Merit-based Incentive Payment System (MIPS)

Final score
76.66 of 100Reported as group
Quality
58.46
Promoting interoperability
83
Improvement activities
40
Cost
77.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1615GAMDClinical Psychologist
5146GAMDChiropractor
001615GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Choice Urgent Care, LLC CurrentSince Nov 12, 2016 Accepting new patients
Atlanta Innovative Medicine, LLC PastSince Nov 3, 2019 Accepting new patients
Cartersville Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Georgia Heart & Vascular Center PC Past Accepting new patients
Meyer Cardiology, PC Past Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients
Total Healthcare II, LLC Past Accepting new patients

Locations

2690 Hamilton Mill Rd
Ste 100
Buford, GA 30519
Phone (470) 326-7300

4215 Pleasant Hill Rd
Duluth, GA 30096
Phone (470) 451-0655

7386 Friendship Springs Blvd
Ste J
Flowery Branch, GA 30542
Phone (470) 451-0646

665 Duluth Hwy
Ste B
Lawrenceville, GA 30046
Phone (470) 451-0650

2745 Loganville Hwy
Loganville, GA 30052
Phone (470) 655-2364

2316 Wisteria Dr
Ste 100
Snellville, GA 30078
Phone (470) 450-0644

5910 Suwanee Dam Rd
#100
Sugar Hill, GA 30518
Phone (470) 326-7600

216 Centerview Dr
Ste 100
Brentwood, TN 37027

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1760677322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 WALTHER RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468725",
            "telephone_number": "770-290-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2536 LAWRENCEVILLE HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333227",
            "telephone_number": "770-934-6832",
            "fax_number": "770-934-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFER",
        "first_name": "ALYSHA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005146",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "001615",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "1615",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225403045 A & B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.