Individual provider Active NPI

Elias Dagnew, M.D.

  • Neurological Surgery Physician
  • Johns Creek, GA
National Provider Identifier
1962408930
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME96941 Issued in GA
Practice address
9635 Ventana Way Ste 201
Johns Creek, GA 30022-8622
Phone
(404) 446-4424
Fax
(404) 446-4420
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 054606 GA
Neurological Surgery Physician 207T00000X ME96941 FL
Neurological Surgery Physician 207T00000X ME96941 GA Primary

Addresses

Primary practice location

9635 Ventana Way Ste 201
Johns Creek, GA 30022-8622

Mailing address

11877 Douglas Rd
Suite 102-272
Alpharetta, GA 30005-4325
Phone (404) 446-4424

Other practice location 1

203 Oakside Ln Ste A
Canton, GA 30114-6407
Phone (404) 446-4424

Other identifiers 2

IdentifierTypeStateIssuer
838984626AMedicaidGA
277245100MedicaidFL

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
I20040720000700 GA Practitioner - Neurosurgery 0244219426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Washington University School of Medicine, 1997
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
Georgia Brain and Spine CenterGroup PAC ID 0042351025, 3 clinicians

Practice addresses (Care Compare)

4700 Nelson Brogdon Blvd
Buford, GA 30518-5401
Phone (770) 271-3188

9635 Ventana Way
Suite 201
Johns Creek, GA 30022-8622
Phone (404) 446-4424

Hospital & facility affiliations

  • Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
  • Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225
  • Union General Hospital Hospital, Blairsville, GA, CCN 110051
  • Adventhealth Murray Hospital, Chatsworth, GA, CCN 110050
  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion25
Laminectomy or laminotomy (partial removal of spine bones)28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME96941FLMDNeurological Surgery Physician
054606GAMDNeurological Surgery Physician
ME96941GAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Brain & Spine Center Neurological Surgery CurrentSince Nov 2, 2009 Accepting new patients
Atlanta Neurosurgical Associates, P.a. Neurological Surgery Past Accepting new patients
Memorial Neurosurgery Group LLC Neurological Surgery Past Accepting new patients

Locations

203 Oakside Ln
Ste E
Canton, GA 30114

203 Oakside Ln
Ste A
Canton, GA 30114
Phone (404) 446-4424

203 Oakside Ln
Ste C
Canton, GA 30114
Phone (470) 410-7911

9635 Ventana Way
Ste 201
Johns Creek, GA 30022
Phone (404) 446-4424

11877 Douglas Rd
#102272
Johns Creek, GA 30005

11877 Douglas Rd
Ste 102272
Johns Creek, GA 30005

9635 Ventana Way
Johns Creek, GA 30022

5491 Roswell Rd
Ste B
Sandy Springs, GA 30342
Phone (404) 252-6662

4385 Johns Creek Pkwy
Ste 200
Suwanee, GA 30024
Phone (770) 349-9861

4355 Johns Creek Pkwy
Ste 520
Suwanee, GA 30024
Phone (404) 446-4424

Interoperability endpoints

  • Direct secure messaging: elias.dagnew.p2@direct.aicaorthopedics.nextgenshare.com
  • Direct secure messaging: elias.dagnew.p1@direct.aicaorthopedics.nextgenshare.com

Organizations & group practices 3

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1962408930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11877 DOUGLAS RD",
            "address_2": "SUITE 102-272",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054325",
            "telephone_number": "404-446-4424",
            "fax_number": "404-446-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9635 VENTANA WAY STE 201",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300228622",
            "telephone_number": "404-446-4424",
            "fax_number": "404-446-4420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 Oakside Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301146407",
            "country_code": "US",
            "telephone_number": "404-446-4424",
            "fax_number": "404-446-4420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAGNEW",
        "first_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "054606",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME96941",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "ME96941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "838984626A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277245100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.