Individual provider Active NPI

Timilehin O Wusu, MD

  • Orthopaedic Surgery Physician
  • Lawrenceville, GA
National Provider Identifier
1942648944
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
84194 Issued in GA
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

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191121002097 GA Practitioner - Orthopedic Surgery 8224266283 Reassigns benefits to 1 organization

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 IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

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 Hospital, Duluth, GA, CCN 110252
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Procedures performed for Medicare patients

ProcedureNumber 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

LicenseStateTypeSpecialty
84194GAMDOrthopaedic Surgery Physician
L-255376MAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC CurrentSince Oct 1, 2019 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.

Hospital & facility affiliations 5

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

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

Verify at the official NPI Registry.