BETH DZICZKOWSKI NURSE PRACTITIONER
NPI 1134014657
Nurse Practitioner - Acute Care in Canton, GA
About Beth Dziczkowski Nurse Practitioner NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BETH DZICZKOWSKI NURSE PRACTITIONER (NPI 1134014657) is an individual acute care provider in Canton, Georgia, licensed in Georgia (RN264561) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Cherokee, and is a graduate of Other (2025).
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
Beth Dziczkowski Nurse Practitioner 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 Beth Dziczkowski reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Atlanta, GA 30342
- Reassigned Medicare billing, Georgia enrollment
- 783 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Northside Hospital Cherokee
Acute Care Hospitals · Canton, GAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30115 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Beth Dziczkowski's NPI number?
The NPI number for Beth Dziczkowski is 1134014657. It was assigned to this individual provider in the NPPES registry on June 12, 2025.
Where is Beth Dziczkowski located?
Beth Dziczkowski practices at 406 Kings Point Dr, Canton, GA 30115. The listed phone number is (404) 966-9296.
What is Beth Dziczkowski's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Beth Dziczkowski enrolled in Medicare?
Yes. Beth Dziczkowski 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 Beth Dziczkowski's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Beth Dziczkowski reassigns Medicare benefits to North Atlanta Professional Services LLC (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 Beth Dziczkowski's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Beth Dziczkowski affiliated with any hospitals?
According to CMS data, Beth Dziczkowski is affiliated with Northside Hospital Cherokee.
When was this NPI record last updated?
The NPPES record for Beth Dziczkowski was last updated on June 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Beth Dziczkowski, NURSE PRACTITIONER · NPI 1134014657
Acute Care physician in Canton, Georgia. Individual provider, active in the CMS NPPES registry since June 12, 2025.
## Identity
- **NPI:** 1134014657 (Entity type: Individual)
- **Enumerated:** June 12, 2025
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** RN264561 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 406 KINGS POINT DR, Canton, GA 30115-5210
- **Phone:** (404) 966-9296
## 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:** North Atlanta Professional Services LLC (NPI 1316959869, Atlanta, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** June 12, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1134014657) · Data from the CMS NPPES public registry.