Michael Anthony Avidano, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

039722 Issued in GA

Practice address

1101 Hospital Dr
Ste 100a
Stockbridge, GA 30281-9076

Phone

(770) 474-7416

Fax

(770) 389-6210

NPI assigned

Jun 27, 2005

Last updated

Jan 4, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Otolaryngology

Education

University of Michigan Medical School, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Atlanta Ear Nose and Throat PCGroup PAC ID 7113908302, 12 clinicians

Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
• Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.518
• Direct secure messaging: mavidano@scent.gwaydirect.com

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.

• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  Medicare reassignment Care Compare group NPD
• South Atlanta Ear Nose & Throat, PC

  • Specialist
  • Fayetteville, GA
  • NPI 1548697196
  Medicare reassignment Care Compare group NPD
• Aylo Health, LLC

  • Diagnostic Radiology Physician
  • Locust Grove, GA
  • NPI 1194433219
  NPD
• Aylo Health, LLC

  • Family Medicine Physician
  • Ellenwood, GA
  • NPI 1447290218
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)
• ENT of Georgia, LLC

  • Otolaryngology Physician
  • Atlanta, GA
  • NPI 1922046424
  NPD (past)
• Piedmont Medical Care Corporation

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1912956046
  NPD (past)
• South Atlanta Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Stockbridge, GA
  • NPI 1528480076
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fayette Community Hospital, Inc.

  dba Piedmont Fayette Hospital

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  Care Compare affiliation
• Kennestone Hospital, Inc.

  dba Wellstar Windy Hill Hospital

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation
• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  Care Compare affiliation

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1780680462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 HOSPITAL DR",
            "address_2": "SUITE 100A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819075",
            "telephone_number": "770-474-7416",
            "fax_number": "770-389-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HOSPITAL DR",
            "address_2": "STE 100A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819076",
            "telephone_number": "770-474-7416",
            "fax_number": "770-389-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVIDANO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "039722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000674726",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desmond Atwell
• Audiology Services Company USA, LLC
• Deborah Auguste, LPC
• Autism Specialty Services LLC
• Daniel Thomas Avendano Powers
• Ax Stockbridge Services Inc
• Jeffrey Ayers, LPC
• Aylo Health, LLC
• Aylo Health, LLC
• Aylo Health, LLC

• Otolaryngology Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Otolaryngology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.

Verify at the official NPI Registry.