EMMANUEL GWIBUKA – Family Nurse Practitioner, NPI 1063248631

EMMANUEL GWIBUKA is a healthcare provider. based in Lawrenceville, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. RN253946 (GA). The NPI Number for EMMANUEL GWIBUKA is 1063248631

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
EMMANUEL GWIBUKA
NPI
1063248631
Phone
(404) 933-7792
Address
776 DONINGTON CIR
Enumeration Date
11 September 2024
Last Update Date
11 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7708443200
Graduation Year
2023 (3 years ago)
PAC ID
6305371931
Group Practice PAC ID
9739189838
Professional Enrollment ID
I20241119004846
Address ID
GA300417659CU1200XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for EMMANUEL GWIBUKA

  • 776 DONINGTON CIR

    LAWRENCEVILLE, GA 300453576

    Phone: (404) 933-7792

    Type: Mailing

  • 1000 JOHNSON FY RD NE

    ATLANTA, GA 303421606

    Phone: (404) 851-8000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $23.

Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.

Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Teleflex LLC ($23).

Total Amount

$23

General + Research + Ownership

Payments

1

Total payment records

General Amount

$23

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-03

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Teleflex LLC$23
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241119004846INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30045)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739189838View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)GA
Cardiovascular Disease (Cardiology), Cardiac ElectrophysiologyGA
-GA
Internal Medicine, Cardiovascular Disease (Cardiology)GA
Cardiovascular Disease (Cardiology)GA
Physician AssistantOH
Physician AssistantGA
Cardiovascular Disease (Cardiology)GA
Nurse PractitionerGA
Cardiovascular Disease (Cardiology)GA

Reviews

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Frequently asked questions

Does EMMANUEL GWIBUKA share an NPI with anyone else?
NPI numbers are unique to each provider or organization — EMMANUEL GWIBUKA uses 1063248631.
Is EMMANUEL GWIBUKA listed as active for patients and plans?
The listing shows EMMANUEL GWIBUKA as active in the NPI system.
What is EMMANUEL GWIBUKA best known for clinically?
Directory data describes EMMANUEL GWIBUKA with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is EMMANUEL GWIBUKA based?
EMMANUEL GWIBUKA is tied to Lawrenceville, Georgia in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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