GEORGIA UROLOGY, PA
NPI 1093369795
Urology in Canton, GA
About Georgia Urology, Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GEORGIA UROLOGY, PA (NPI 1093369795) is a healthcare organization registered as an urology in Canton, Georgia and active in the NPI registry since July 2019. The organization holds a CLIA Microscopy certificate valid through March 24, 2028 and lists Dan Fellner, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Georgia Urology, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
115Medicare enrollment records show 115 clinicians reassign Medicare billing to Georgia Urology, PA, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 8 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 4
Nearest to this location (20)
See all 115Canton, GA 30115
Canton, GA 30115
Atlanta, GA 30342
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 11D0943320
Georgia Urology PA, Canton · Canton, GAFrequently 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 Georgia Urology, PA's NPI number?
The NPI number for Georgia Urology, PA is 1093369795. It was assigned to this organization in the NPPES registry on July 31, 2019.
Where is Georgia Urology, PA located?
Georgia Urology, PA is located at 470 Northside Cherokee Blvd Ste 210, Canton, GA 30115. The listed phone number is (770) 720-7246.
What is Georgia Urology, PA's specialty?
The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.
Is Georgia Urology, PA enrolled in Medicare?
Yes. Georgia Urology, PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Georgia Urology, PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 115 clinicians in 4 Medicare specialties reassign their Medicare billing to Georgia Urology, PA. A 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 the clinician's services. The largest specialties are Urology (83), Nurse Practitioner (29) and Interventional Radiology (2). Of these, 2 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Georgia Urology, PA hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D0943320) is associated with this NPI, valid through March 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Georgia Urology, PA was last updated on May 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Georgia Urology, Pa · NPI 1093369795
Urology organization in Canton, Georgia. Organization record, active in the CMS NPPES registry since July 31, 2019.
## Identity
- **NPI:** 1093369795 (Entity type: Organization)
- **Enumerated:** July 31, 2019
- **Primary specialty:** Urology · taxonomy 208800000X
- **Organization subpart:** Yes (part of Georgia Urology Pa)
- **Authorized official:** Dan Fellner, CEO
## Practice location
- **Address:** 470 NORTHSIDE CHEROKEE BLVD STE 210, Canton, GA 30115-8029
- **Phone:** (770) 720-7246
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 115 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Urology (83), Nurse Practitioner (29), Interventional Radiology (2); 2 practice at this address and 8 within 10 miles; [full list](https://npiprofile.com/npi/1093369795/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 6, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1093369795) · Data from the CMS NPPES public registry.