MR. ETHAN JACOB WAJSWOL MD (5/18/2020)
NPI 1366076945
Urology in Canton, GA

Q: What is Ethan Wajswol's NPI number?

The NPI number for Ethan Wajswol is 1366076945. It was assigned to this individual provider in the NPPES registry on February 24, 2020.

Q: What is Ethan Wajswol's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Wajswol was last updated on June 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since February 24, 2020PECOS EnrolledAccepts Medicare Assignment

470 NORTHSIDE CHEROKEE BLVD STE 201, CANTON, GA 30115(770) 720-7246(770) 720-4620 Get Directions Write a Review

NPPES record last updated: June 26, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 26, 2025, Mar 28, 2025, Jan 11, 2022 and 2 more (5 updates tracked since 2020).

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About Mr. Ethan Jacob Wajswol Md (5/18/2020) NPPES

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

MR. ETHAN JACOB WAJSWOL MD (5/18/2020) (NPI 1366076945) is an individual urology provider in Canton, Georgia, licensed in Georgia (99892) and active in the NPI registry since February 2020. He is enrolled in Medicare PECOS, is affiliated with Mayo Clinic, and is a graduate of Rutgers New Jersey Medical School (2020).

NPPES Registry Identity

NPI1366076945

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameMR. ETHAN JACOB WAJSWOLCredential: MD (5/18/2020)

Location Address470 NORTHSIDE CHEROKEE BLVD STE 201Canton, GA 30115-8029

Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040

Phone(770) 720-7246

Fax(770) 720-4620

Sole ProprietorNo

Medical School CMSRutgers New Jersey Medical SchoolGraduated 2020

Enumeration DateFebruary 24, 2020

Last NPPES UpdateJune 26, 20255 updates tracked since enumeration

NPPES CertifiedJune 26, 2025

✔ NPI 1366076945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in GA · 99892

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.

470 NORTHSIDE CHEROKEE BLVD STE 201, Canton, GA 30115

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Ethan Jacob Wajswol Md (5/18/2020) 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.

PECOS PAC ID2466875133

PECOS Enrollment IDI20240926003827, I20250509003184

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.

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mayo Clinic

Acute Care Hospitals · Jacksonville, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100151

Location4500 San Pablo RdJacksonville, FL 32224 · Duval County

Emergency services

Northside Hospital Cherokee

Acute Care Hospitals · Canton, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110008

Location450 Northside Cherokee BoulevardCanton, GA 30115 · Cherokee County

Emergency services Birthing friendly

Piedmont Cartersville Medical Center

Acute Care Hospitals · Cartersville, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110030

Location960 Joe Frank Harris ParkwayCartersville, GA 30120 · Bartow County

Emergency services Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Piedmont Mountainside Hospital Inc

Acute Care Hospitals · Jasper, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110225

Location1266 Highway 515 SouthJasper, GA 30143 · Pickens County

Birthing friendly

Physician 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.

New Patient

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

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 7

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

EMILY PATRICIA ANDREANO

Physician Assistant