GISELE WOGBO
NPI 1063156636
Family Medicine in Kennesaw, GA
About Gisele Wogbo NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GISELE WOGBO (NPI 1063156636) is an individual family medicine provider in Kennesaw, Georgia, licensed in Georgia (104254) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2009).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Gisele Wogbo is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Gisele Wogbo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Atlanta, GA 30305
- Reassigned Medicare billing, Georgia enrollment
- 1,389 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30144 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
KENNESAW, GA 30144
KENNESAW, GA 30144
KENNESAW, GA 30144
KENNESAW, GA 30144
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Gisele Wogbo's NPI number?
The NPI number for Gisele Wogbo is 1063156636. It was assigned to this individual provider in the NPPES registry on April 20, 2022.
Where is Gisele Wogbo located?
Gisele Wogbo practices at 750 Townpark Ln NW, Kennesaw, GA 30144. The listed phone number is (404) 365-0966.
What is Gisele Wogbo's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Gisele Wogbo enrolled in Medicare?
Yes. Gisele Wogbo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Gisele Wogbo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Gisele Wogbo reassigns Medicare benefits to The Southeast Permanente Medical Group (Atlanta, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gisele Wogbo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Gisele Wogbo was last updated on September 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Gisele Wogbo · NPI 1063156636
Family Medicine physician in Kennesaw, Georgia. Individual provider, active in the CMS NPPES registry since April 20, 2022.
## Identity
- **NPI:** 1063156636 (Entity type: Individual)
- **Enumerated:** April 20, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 104254 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 750 TOWNPARK LN NW, Kennesaw, GA 30144-5579
- **Phone:** (404) 365-0966
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** The Southeast Permanente Medical Group (NPI 1245266956, Atlanta, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2009
## Record status
- **NPPES last updated:** September 16, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1063156636) · Data from the CMS NPPES public registry.