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KENZIE DITTMAR PA
NPI 1265228795
Physician Assistant in Dallas, GA

Active since April 21, 2025PECOS Enrolled
850 CHARLES HARDY PKWY, DALLAS, GA 30157(770) 336-8888 Get Directions Write a Review

NPPES record last updated: January 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kenzie Dittmar Pa NPPES

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

KENZIE DITTMAR PA (NPI 1265228795) is an individual physician assistant in Dallas, Georgia and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS, maintains a secondary practice location in Cartersville, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1265228795
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKENZIE DITTMARCredential: PA
Location Address850 CHARLES HARDY PKWYDallas, GA 30157-3163
Mailing Address1502 N Amanda Cir NeAtlanta, GA 30329-3320
Phone(770) 336-8888
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateApril 21, 2025
Last NPPES UpdateJanuary 29, 2026
NPPES CertifiedJanuary 29, 2026
✔ NPI 1265228795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
850 CHARLES HARDY PKWY, Dallas, GA 30157
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Other Names 1

Professional Name (2)Kenzie Pierce Dittmar Pa

Secondary Practice Location 1

Location 110 Cloverleaf DrCartersville, GA 30120-2178 · Phone (770) 606-8026

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenzie Dittmar Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2567951916
PECOS Enrollment IDI20251027004498
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30157 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. NATALIE ANN MERCADO PA-C
Physician Assistant (Medical)
850 CHARLES HARDY PKWY
DALLAS, GA 30157
Paulding County (770) 336-8888

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 Kenzie Dittmar's NPI number?

The NPI number for Kenzie Dittmar is 1265228795. It was assigned to this individual provider in the NPPES registry on April 21, 2025. The provider is also known as Kenzie Pierce Dittmar PA.

Where is Kenzie Dittmar located?

Kenzie Dittmar practices at 850 Charles Hardy Pkwy, Dallas, GA 30157. The listed phone number is (770) 336-8888.

What is Kenzie Dittmar's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kenzie Dittmar enrolled in Medicare?

Yes. Kenzie Dittmar is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenzie Dittmar was last updated on January 29, 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.