JOHN CARMEN DERCOLA (PA) – Medical Physician Assistant, NPI 1417952433

JOHN CARMEN DERCOLA (PA) is a healthcare provider. based in Marietta, Georgia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 002707 (GA). The NPI Number for JOHN CARMEN DERCOLA (PA) is 1417952433

Main info

Male
41 Years Of Experience
Accepts Medicare Assignment
Name
JOHN CARMEN DERCOLA (PA)
NPI
1417952433
Phone
(770) 424-6893
Address
55 WHITCHER ST NE
Enumeration Date
16 June 2005
Last Update Date
2 January 2013

Doctor Profile

Medical School Name
HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
7704248222
Graduation Year
1985 (41 years ago)
PAC ID
4587723663
Group Practice PAC ID
6709065402
Professional Enrollment ID
I20081104000444
Address ID
GA301527742KE5150XRDXX501
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,430 PHYSICIAN ASSISTANT in GA

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Provider Addresses for JOHN CARMEN DERCOLA (PA)

  • 55, Whitcher Street Northwest, Elizabeth, Marietta, Cobb, Georgia, 30060, United States

    SUITE 350

    MARIETTA, GA 300601155

    Phone: (770) 424-6893

    Fax: (770) 528-9926

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $460.

Total Amount is formed as General ($460) + Research ($0) + Ownership ($0) = $460.

Last reported payment date: 2024-10-29 • Largest payer in this snapshot: ATRICURE, INC. ($148).

Total Amount

$460

General + Research + Ownership

Payments

11

Total payment records

General Amount

$460

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-29

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-11-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20081104000444IPhysician AssistantGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes134115$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report3431$0
View full utilization report →

Insurance plans in this area (ZIP 30060)

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Provider's Procedures

JOHN CARMEN DERCOLA (PA) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTGA93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report140134

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709065402View full group profile
NameSpecialtyState
-GA
-GA
-GA
R H E U M A T O L O G YMI
Hospitalist, Internal MedicineGA
Nurse PractitionerTN
Family PracticeGA
Physician AssistantGA
Physician AssistantGA
Hospitalist, Internal MedicineGA

Reviews

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Frequently asked questions

What identifier follows JOHN CARMEN DERCOLA (PA) across health systems?
The NPI 1417952433 uniquely identifies JOHN CARMEN DERCOLA (PA) in U.S. healthcare data.
Quick check: is JOHN CARMEN DERCOLA (PA) active?
Public NPPES data shows JOHN CARMEN DERCOLA (PA) with an active NPI status right now.
What does the directory say JOHN CARMEN DERCOLA (PA) does?
Insurance directories may phrase it differently, but here JOHN CARMEN DERCOLA (PA) maps to Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is JOHN CARMEN DERCOLA (PA) tied to Marietta, Georgia?
If you are local to Marietta, Georgia, JOHN CARMEN DERCOLA (PA) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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