EMMANUEL D DAFIVBIRORO APRN
NPI 1215633912
Nurse Practitioner - Primary Care in Stone Mountain, GA
About Emmanuel D Dafivbiroro Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EMMANUEL D DAFIVBIRORO APRN (NPI 1215633912) is an individual primary care provider in Stone Mountain, Georgia, licensed in Georgia (APRN-NP154440) and active in the NPI registry since February 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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
Emmanuel D Dafivbiroro Aprn 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 Reassignments
2Medicare enrollment records show Emmanuel Dafivbiroro reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Newnan, GA 30265
- Reassigned Medicare billing, Georgia enrollment
- 380 clinicians in this Medicare group
Dallas, TX 75244
- Reassigned Medicare billing, Georgia enrollment
- 488 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.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30087 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
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Emmanuel Dafivbiroro's NPI number?
The NPI number for Emmanuel Dafivbiroro is 1215633912. It was assigned to this individual provider in the NPPES registry on February 3, 2023.
Where is Emmanuel Dafivbiroro located?
Emmanuel Dafivbiroro practices at 6297 Robins Trce, Stone Mountain, GA 30087. The listed phone number is (770) 413-1424.
What is Emmanuel Dafivbiroro's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Emmanuel Dafivbiroro enrolled in Medicare?
Yes. Emmanuel Dafivbiroro 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 organizations bill Medicare for Emmanuel Dafivbiroro's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Emmanuel Dafivbiroro reassigns Medicare benefits to 2 organizations: Wellstreet Of Georgia PC (Newnan, GA) and Signify Health Medical Associates, PLLC (Dallas, TX). Each 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 Emmanuel Dafivbiroro's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Emmanuel Dafivbiroro accept?
Health plans from CareSource (Common Ground Healthcare) list Emmanuel Dafivbiroro as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Emmanuel Dafivbiroro was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Emmanuel D Dafivbiroro, APRN · NPI 1215633912
Primary Care physician in Stone Mountain, Georgia. Individual provider, active in the CMS NPPES registry since February 3, 2023.
## Identity
- **NPI:** 1215633912 (Entity type: Individual)
- **Enumerated:** February 3, 2023
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** APRN-NP154440 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 6297 ROBINS TRCE, Stone Mountain, GA 30087-6537
- **Phone:** (770) 413-1424
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Wellstreet Of Georgia PC (NPI 1235411547, Newnan, GA); Signify Health Medical Associates, PLLC (NPI 1750845863, Dallas, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** October 29, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1215633912) · Data from the CMS NPPES public registry.