Active NPI
Timilehin O Wusu, MD
- Orthopaedic Surgery Physician
- Lawrenceville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 84194
- Practice address
- 771 Old Norcross Rd Ste 105
Lawrenceville, GA 30046-4977 - Phone
- (855) 647-7678
- Fax
- (404) 847-4232
- NPI assigned
- Jun 12, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 84194 | GA | Primary |
| Orthopaedic Surgery Physician | 207X00000X | L-255376 | MA |
Addresses
Primary practice location
771 Old Norcross Rd Ste 105
Lawrenceville, GA 30046-4977
Mailing address
Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Phone (617) 726-2942
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | NCOSM@Northside.gwaydirect.com | Direct |
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
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Northwestern University Feinberg Medical School, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Physiotherapy Associates Inc
Practice addresses (Care Compare)
3680 Pleasant Hill Rd
Suite 101
Duluth, GA 30096-3268
Phone (770) 813-5575
900 Towne Lake Pkwy
Suite 320
Woodstock, GA 30189-1604
Phone (770) 517-6636
Hospital & facility affiliations
- Northside Hospital Duluth
- Northside Hospital Gwinnett
- Northside Hospital Forsyth
- Northside Hospital
- Wellstar Windy Hill Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 22 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84194 | GA | MD | Orthopaedic Surgery Physician |
| L-255376 | MA | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northside Surgical Professional Services LLC | Current | Accepting new patients |
Locations
771 Old Norcross Rd
Ste 105
Lawrenceville, GA 30046
Phone (770) 509-4030
1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000
1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737
900 Towne Lake Pkwy
Ste 320
Woodstock, GA 30189
Phone (770) 517-6636
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.
-
- Surgery Physician
- Atlanta, GA
- NPI 1356630990
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Long Term Care Hospital
- Marietta, GA
- NPI 1700853041
Long-term care hospital
-
- General Acute Care Hospital
- Cumming, GA
- NPI 1376574277
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1457396079
-
- General Acute Care Hospital
- Duluth, GA
- NPI 1790715381
-
- General Acute Care Hospital
- Lawrenceville, GA
- NPI 1952340994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614297600000",
"number": "1942648944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MASSACHUSETTS GENERAL HOSPITAL",
"address_2": "55 FRUIT ST.",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-726-2942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "771 OLD NORCROSS RD STE 105",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300464977",
"telephone_number": "855-647-7678",
"fax_number": "404-847-4232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUSU",
"first_name": "TIMILEHIN",
"middle_name": "O",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-12",
"last_updated": "2021-02-26",
"certification_date": "2021-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "GA",
"license": "84194",
"primary": true
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MA",
"license": "L-255376",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "NCOSM@Northside.gwaydirect.com",
"affiliation": "N",
"endpointDescription": "Direct Messaging",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Edge",
"address_1": "771 Old Norcross Rd Ste 105",
"city": "Lawrenceville",
"state": "GA",
"country_code": "US",
"postal_code": "300464977",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.