Individual provider Active NPI

Tewelde Araya

  • Physician Assistant
  • Loganville, GA
National Provider Identifier
1972220739
Registry record updated Jun 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4072 Atlanta Hwy
Loganville, GA 30052-2297
Phone
(678) 905-0236
NPI assigned
Oct 24, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4072 Atlanta Hwy
Loganville, GA 30052-2297

Mailing address

4072 Atlanta Hwy
Loganville, GA 30052-2297
Phone (678) 905-0236

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410002847 GA Practitioner - Physician Assistant 7113365032 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary and Sleep Specialists of Piedmont NortheastGroup PAC ID 5698209096, 18 clinicians
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

2151 W Spring St
Suite B110
Monroe, GA 30655-3209
Phone (770) 586-0300

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2804
Phone (770) 222-8900

4072 Atlanta Hwy
Loganville, GA 30052-2297
Phone (678) 905-0236

Hospital & facility affiliations

  • Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary and Sleep Specialists of Piedmont Northeast CurrentSince Jan 3, 2026 Accepting new patients
Pulmonary and Sleep Specialists of Northeast Georgia, PC CurrentSince Jan 3, 2026 Accepting new patients

Locations

2075 Hamilton Creek Pkwy
Ste 200
Dacula, GA 30019
Phone (770) 586-0300

2151 W Spring St
Ste B110
Monroe, GA 30655
Phone (770) 267-1895

1800 Tree Ln
Ste 200
Snellville, GA 30078
Phone (770) 586-0300

30 Satellite Dr
Ste 200
Winder, GA 30680
Phone (770) 586-0300

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 1

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": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718496000000",
    "number": "1972220739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4072 ATLANTA HWY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522297",
            "telephone_number": "678-905-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4072 ATLANTA HWY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522297",
            "telephone_number": "678-905-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARAYA",
        "first_name": "TEWELDE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-06-16",
        "certification_date": "2024-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

Verify at the official NPI Registry.