Active NPI
Oluwasheyi Akin Ayeni, M.D.
- Student in an Organized Health Care Education/Training Program
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1364 Clifton Rd NE
Atlanta, GA 30322-1059 - Phone
- (404) 727-5004
- Fax
- (404) 727-3157
- NPI assigned
- Apr 23, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Mailing address
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 727-5004
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Permanente Medical Group |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181024002503 | GA | Practitioner - Neurology | 6608129408 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Emory University School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- The Southeast Permanente Medical GroupPhysiotherapy Associates Inc
Practice addresses (Care Compare)
2470 Mount Zion Pkwy
BLDG 200
Jonesboro, GA 30236-2500
Phone (770) 527-9031
40 Greenway CT
Suite Bandc
Newnan, GA 30265-2326
Phone (770) 502-0195
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Southeast Permanente Medical Group | Current | Accepting new patients |
Locations
3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000
2470 Mount Zion Pkwy
Bldg 200
Jonesboro, GA 30236
Phone (770) 527-9031
2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3649
20 Glenlake Pkwy
Sandy Springs, GA 30328
Phone (770) 677-6247
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642464000000",
"number": "1801154232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1364 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221059",
"telephone_number": "404-727-5004",
"fax_number": "404-727-3157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1364 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221059",
"telephone_number": "404-727-5004",
"fax_number": "404-727-3157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYENI",
"first_name": "OLUWASHEYI",
"middle_name": "AKIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-23",
"last_updated": "2022-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "2400 Mount Zion Pkwy",
"city": "Jonesboro",
"state": "GA",
"country_code": "US",
"postal_code": "302362500",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.