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

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: October 25, 2026.

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

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
Open in Google Maps ↗

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, billing reassignment, and ordering and referring status from CMS.

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 IDI20250509003184
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Ethan Wajswol reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Georgia Urology, PA
Same address
Urology
470 NORTHSIDE CHEROKEE BLVD STE 210
Canton, GA 30115
  • Reassigned Medicare billing, Georgia enrollment
  • 115 clinicians in this Medicare group
NPI 1093369795 (770) 720-7246
Urological Professional Services, LLC
23 mi
Urology
1000 JOHNSON FY RD NE
Atlanta, GA 30342
  • Reassigned Medicare billing, Georgia enrollment
  • 95 clinicians in this Medicare group
NPI 1033521810 (855) 709-4535
Mayo Clinic Jacksonville
326 mi
Health Service
4500 SAN PABLO RD S
Jacksonville, FL 32224
  • Reassigned Medicare billing, Florida enrollment
  • 1,828 clinicians in this Medicare group
NPI 1174143986 (904) 953-2000

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 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
470 NORTHSIDE CHEROKEE BLVD STE 201
CANTON, GA 30115
Cherokee County (770) 720-7246
HEATHER WAGNER
Physician Assistant
470 NORTHSIDE CHEROKEE BLVD STE 201
CANTON, GA 30115
Cherokee County (770) 720-7246
MR. VINCENT DANIEL DICARLO MD
Urology
470 NORTHSIDE CHEROKEE BLVD STE 201
CANTON, GA 30115
Cherokee County (770) 720-7246
CARL C CAPELOUTO M.D.
Urology
470 NORTHSIDE CHEROKEE BLVD STE 201
CANTON, GA 30115
Cherokee County (770) 720-7246
DR. YASIN BHANJI MD
Urology
470 NORTHSIDE CHEROKEE BLVD STE 201
CANTON, GA 30115
Cherokee County (770) 720-7246
GEORGIA UROLOGY PA
Urology
470 NORTHSIDE CHEROKEE BLVD STE 201
CANTON, GA 30115
Cherokee County (770) 720-7246
GEORGIA UROLOGY PA
Urology
470 NORTHSIDE CHEROKEE BLVD STE 201
CANTON, GA 30115
Cherokee County (770) 720-7246

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 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.

Where is Ethan Wajswol located?

Ethan Wajswol practices at 470 Northside Cherokee Blvd Ste 201, Canton, GA 30115. The listed phone number is (770) 720-7246.

What is Ethan Wajswol's specialty?

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

Is Ethan Wajswol enrolled in Medicare?

Yes. Ethan Wajswol 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 organizations bill Medicare for Ethan Wajswol's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Wajswol reassigns Medicare benefits to 3 organizations: Georgia Urology, PA (Canton, GA), Urological Professional Services, LLC (Atlanta, GA) and Mayo Clinic Jacksonville (Jacksonville, FL). Each 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 Ethan Wajswol's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ethan Wajswol accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Ethan Wajswol 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.

Is Ethan Wajswol affiliated with any hospitals?

According to CMS data, Ethan Wajswol is affiliated with Mayo Clinic, Northside Hospital Cherokee, Piedmont Cartersville Medical Center, Northside Hospital and Piedmont Mountainside Hospital Inc.

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 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.