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GEORGIA UROLOGY PA
NPI 1245250646
Urology in Riverdale, GA

Active since July 20, 2006CLIA 11D0902137 · Microscopy
33 UPPER RIVERDALE RD SW, SUITE 105, RIVERDALE, GA 30274(770) 991-0020(770) 994-9729 Get Directions Write a Review

NPPES record last updated: May 6, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Georgia Urology Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GEORGIA UROLOGY PA (NPI 1245250646) is a healthcare organization registered as an urology in Riverdale, Georgia and active in the NPI registry since July 2006. The organization holds a CLIA Microscopy certificate valid through July 6, 2028 and lists Dan Fellner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1245250646
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameGEORGIA UROLOGY PA
Location Address33 UPPER RIVERDALE RD SW, SUITE 105Riverdale, GA 30274-2626
Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040 · Fax (678) 284-4076
Phone(770) 991-0020
Fax(770) 994-9729
Organization SubpartNo
Authorized OfficialDan FellnerCeo · (678) 205-8360
Enumeration DateJuly 20, 2006
Last NPPES UpdateMay 6, 2026
NPPES CertifiedMay 6, 2026
✔ NPI 1245250646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
33 UPPER RIVERDALE RD SW, Riverdale, GA 30274
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Other Identifiers 1

OtherGRP1552GA · Group Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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

116

Medicare enrollment records show 116 clinicians reassign Medicare billing to Georgia Urology PA, which bills Medicare for the services they deliver. Of these, 4 practice at this address. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 4

Urology84
Nurse Practitioner29
Interventional Radiology2
Diagnostic Radiology1

Nearest to this location (20)

See all 116
Darrell Carmen, M.D.
Urology
NPI 1447368626
33 UPPER RIVERDALE RD SW SUITE 105
Riverdale, GA 30274
(770) 991-0020
✔ PECOS✔ Accepts MedicareSame address
Anastasiya Drogoul, NP
Nurse Practitioner
NPI 1922623610
33 UPPER RIVERDALE RD SW STE 105
Riverdale, GA 30274
(770) 991-0020
✔ PECOS✔ Accepts MedicareSame address
Ayodeji Sotimehin
Urology
NPI 1972969012
33 UPPER RIVERDALE RD SW STE 105
Riverdale, GA 30274
(770) 991-0020
✔ PECOS✔ Accepts MedicareSame address
Barry Zisholtz, M.D.
Urology
NPI 1265441349
33 UPPER RIVERDALE RD SW SUITE 105
Riverdale, GA 30274
(770) 991-0020
✔ PECOSSame address
Anand Shantha, M.D.
Urology
NPI 1225047301
119 N PARK TRL
Stockbridge, GA 30281
(770) 389-3739
✔ PECOS11 mi
Prabhakar Mithal
Urology
NPI 1497172951
1336 HIGHWAY 54 W BLDG 200
Fayetteville, GA 30214
(770) 460-9777
✔ PECOS✔ Accepts Medicare11 mi
Brittani Barrett-Harlow, M.D.
Urology
NPI 1013334390
1336 HIGHWAY 54 W BLDG 200
Fayetteville, GA 30214
(770) 460-9777
✔ PECOS✔ Accepts Medicare11 mi
Jennifer Goodson, NP
Nurse Practitioner
NPI 1104912054
1336 HIGHWAY 54 W BLDG 200
Fayetteville, GA 30214
(770) 460-9777
✔ PECOS✔ Accepts Medicare11 mi
Kevin Yang, M.D.
Urology
NPI 1336402924
1336 HIGHWAY 54 W BLDG 200
Fayetteville, GA 30214
(770) 460-9777
✔ PECOS✔ Accepts Medicare11 mi
John Abbott, M.D.
Urology
NPI 1861679805
1336 HIGHWAY 54 W BLDG 200
Fayetteville, GA 30214
(770) 460-9777
✔ PECOS✔ Accepts Medicare11 mi
Princess Mcgriff, FNP
Nurse Practitioner
NPI 1568185320
1336 HIGHWAY 54 W BLDG 100, SUITE 100
Fayetteville, GA 30214
(770) 460-9777
✔ PECOS✔ Accepts Medicare11 mi
Edan Shapiro, MD
Urology
NPI 1407090459
1336 HIGHWAY 54 W BLDG 200
Fayetteville, GA 30214
(770) 460-9777
✔ PECOS✔ Accepts Medicare11 mi
Robert Dimeglio, M.D.
Urology
NPI 1619929973
95 COLLIER RD NW STE 6025
Atlanta, GA 30309
(404) 352-9260
✔ PECOS✔ Accepts Medicare15 mi
Deena Holloway, FNP-C
Nurse Practitioner
NPI 1396264008
105 COLLIER RD NW STE 3020
Atlanta, GA 30309
(404) 605-4848
✔ PECOS✔ Accepts Medicare15 mi
Corby Barkhaus, NP
Nurse Practitioner
NPI 1841680048
275 COLLIER RD NW STE 400
Atlanta, GA 30309
(404) 605-4848
✔ PECOS16 mi
Brittany Mize, FNP-BC
Nurse Practitioner
NPI 1053067637
2685 MILSCOTT DR
Decatur, GA 30033
(404) 292-3727
✔ PECOS✔ Accepts Medicare16 mi
Ebony Crosland, NP
Nurse Practitioner
NPI 1174236111
2685 MILSCOTT DR
Decatur, GA 30033
(404) 292-3727
✔ PECOS✔ Accepts Medicare16 mi
Catherine Carman, NP-C
Nurse Practitioner
NPI 1588769541
3200 DOWNWOOD CIR NW SUITE 640
Atlanta, GA 30327
(404) 351-0051
✔ PECOS✔ Accepts Medicare18 mi
David Owens, MD
Diagnostic Radiology
NPI 1932284833
4545 HARRIS TRL NW
Atlanta, GA 30327
(404) 277-1502
✔ PECOS21 mi
Jin Park, M.D.
Interventional Radiology
NPI 1649399338
1000 JOHNSON FERRY RD NE RADIOLOGY DEPARTMENT
Atlanta, GA 30342
(404) 851-6323
✔ PECOS✔ Accepts Medicare23 mi
See all 116 clinicians

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) 11D0902137

Georgia Urology PA Riverdale · Riverdale, GA
Active · expires Jul 6, 2028
CLIA Number11D0902137
Laboratory TypePhysician Office
Certificate Effective DateJuly 7, 2026
Certificate Expiration DateJuly 6, 2028
Laboratory DirectorDr. Darrell Carmen
Laboratory Phone(770) 991-0020
Laboratory LocationGeorgia Urology PA Riverdale33 Upper Riverdale Road Suite 105, Riverdale, GA 30274
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Georgia Urology PA's NPI number?

The NPI number for Georgia Urology PA is 1245250646. It was assigned to this organization in the NPPES registry on July 20, 2006.

Where is Georgia Urology PA located?

Georgia Urology PA is located at 33 Upper Riverdale Rd SW Suite 105, Riverdale, GA 30274. The listed phone number is (770) 991-0020.

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), 116 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 (84), Nurse Practitioner (29) and Interventional Radiology (2). Of these, 4 practice at this address. 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 11D0902137) is associated with this NPI, valid through July 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Georgia Urology PA accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Georgia Urology PA 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 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 6 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.