NORTHSIDE EMERGENCY ASSOCIATES, P.C. – Emergency Medicine Physician, NPI 1285686303
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for NORTHSIDE EMERGENCY ASSOCIATES, P.C.
450 Northside Cherokee Blvd
Canton, GA 301158015
Phone: (954) 939-5000
Fax: (484) 342-5201
Type: Location
1200 Northside Forsyth Dr
Cumming, GA 300417659
Phone: (954) 939-5000
Fax: (484) 342-5201
Type: Location
PO BOX 80204
PHILADELPHIA, PA 191011204
Phone: (954) 939-5000
Fax: (484) 342-5201
Type: Mailing
McDonald's, 1000, Johnson Ferry Road Northeast, Ridgeview Forest, Atlanta, Fulton County, Georgia, 30346, United States
ATLANTA, GA 303421606
Phone: (954) 939-5000
Fax: (484) 342-5201
Type: Location
Noel Road, Dallas, Dallas County, Texas, 75254, United States
DALLAS, TX 752401374
Phone: (954) 838-2371
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2004-04-26
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040426000165 | O | Clinic/Group Practice | GA | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30115)
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