Individual provider Active NPI

Tooba Anwar

  • Physician Assistant
  • Gainesville, GA
National Provider Identifier
1891339859
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11646 Issued in GA
Practice address
1475 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3806
Phone
(678) 430-3110
Fax
(678) 928-5955
NPI assigned
Nov 3, 2019
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11646 GA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1475 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3806

Mailing address

1475 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3806
Phone (678) 430-3110

Other practice location 1

160 Convent Ave
New York, NY 10031-9101
Phone (212) 650-7745

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
I20231108001186 GA Practitioner - Cardiovascular Disease (Cardiology) 5698122992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Clinic of North Georgia PCGroup PAC ID 9830350735, 11 clinicians

Practice addresses (Care Compare)

1475 Jesse Jewell Pkwy NE
Suite 300
Gainesville, GA 30501-3806
Phone (678) 430-3110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11646GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Clinic of North Georgia PC CurrentSince Sep 23, 2023 Accepting new patients

Locations

1287 Sims St
Gainesville, GA 30501
Phone (855) 462-8264

1475 Jesse Jewell Pkwy NE
#300
Gainesville, GA 30501
Phone (678) 825-3685

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFEHBA

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, 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": "1572739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1891339859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 JESSE JEWELL PKWY NE STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013806",
            "telephone_number": "678-430-3110",
            "fax_number": "678-928-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 JESSE JEWELL PKWY NE STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013806",
            "telephone_number": "678-430-3110",
            "fax_number": "678-928-5955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Convent Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100319101",
            "country_code": "US",
            "telephone_number": "212-650-7745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANWAR",
        "first_name": "TOOBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-03",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11646",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.