Ashley Agbulos, C-AA
Individual provider Active NPI Anesthesiologist Assistant · Atlanta, GA
NPI 1871003368 · NPPES record last updated Oct 10, 2017
Key facts
- NPI
- 1871003368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiologist Assistant 367H00000X
- License
- 8492 (GA)
- Practice address
- 1000 Johnson Fy Rd NE
Atlanta, GA 30342-1606 - Phone
- (732) 642-3281
- NPI assigned
- Oct 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Anesthesiology Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Atlanta Anesthesia Professionals, LLC
Practice addresses (Care Compare)
1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-8000
Hospital & facility affiliations
- Northside Hospital
- Northside Hospital Cherokee
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180524002606 | GA | Practitioner - Anesthesiology Assistant | 5294090130 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Associate of Arts, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8492 | GA | MD | Anesthesiologist Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Atlanta Anesthesia Professionals, LLC | Current |
Accepting new patients |
Locations
1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356
1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737
1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | 8492 | GA | Yes |
Addresses
Primary practice location
1000 Johnson Fy Rd NE
Atlanta, GA 30342-1606
Mailing address
318 Adams CT
Manalapan, NJ 07726-8701
Other providers in Atlanta, GA
- Uchenna Agbim
- Marie Agbodjan
- Mawuena Agbonyitor
- Foluso Agboola
- Francis Agbotse
- Robert Agee II
- Ageless Mens Health
- Agency for Toxic Substance and Disease Registry (Atsdr)
- Atishi Deepti Aggarwal
- Pasquelle Aggett-Carosella
All providers in Atlanta, GA · Anesthesiologist Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.