NPIMap

Organization Active NPI

Georgia Urology, PA

Doing business as GA Urology ASC Roswell

  • Ambulatory Surgical Clinic/Center
  • Roswell, GA
National Provider Identifier
1952771230
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
GEORGIA UROLOGY, PA
Doing business as
GA Urology ASC Roswell
Practice address
11835 Alpharetta Hwy Ste 100
Roswell, GA 30076-4929
Phone
(770) 475-7550
Fax
(770) 343-9080
NPI assigned
Sep 30, 2015
Last updated
Jun 25, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA UROLOGY, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dan Fellner
Title
Ceo
Phone
(678) 205-8360

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

11835 Alpharetta Hwy Ste 100
Roswell, GA 30076-4929

Mailing address

1930 Brannan Rd
McDonough, GA 30253-4310
Phone (678) 284-4040

Other names 1

  • GA Urology ASC Roswell Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160519002540 GA Part B Supplier - Ambulatory Surgical Center 8921094376 Practice locations: Roswell, GA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Georgia Urology Dba Ga Urology Ambulatory Surgery Center AlpharettaCCN 11C0001447
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Ga Urology ASC Canton53 organizations share this tax ID, including this one
Part of
Ga Urology ASC Canton

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

11835 Alpharetta Hwy
Ste 100
Roswell, GA 30076
Phone (770) 475-7550

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782345600000",
    "number": "1952771230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 ALPHARETTA HWY STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764929",
            "telephone_number": "770-475-7550",
            "fax_number": "770-343-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA UROLOGY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA UROLOGY, PA",
        "enumeration_date": "2015-09-30",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A",
        "authorized_official_last_name": "FELLNER",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-205-8360"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GA Urology ASC Roswell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.