Kevin Joseph Gancarczyk, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

26830 Issued in OK

Practice address

10901 E 48TH St
Tulsa, OK 74146-5830

Phone

(918) 749-8765

Fax

(918) 392-2155

NPI assigned

Feb 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK, AR, MO3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Urology

Education

University of Arkansas College of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McAlester Medical Services LLCGroup PAC ID 9931139029, 21 clinicians

Urologic Specialists of Oklahoma IncGroup PAC ID 3779470091, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062
• Oklahoma Surgical Hospital, LLC Hospital, Tulsa, OK, CCN 370210
• Ascension St John Jane Phillips Hospital, Bartlesville, OK, CCN 370018
• McAlester Regional Health Center Hospital, McAlester, OK, CCN 370034
• Ascension St John Broken Arrow Hospital, Broken Arrow, OK, CCN 370235

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• IA HMO C-SNP
• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
• IA HMO

Interoperability endpoints

• Direct secure messaging: kevin.gancarczyk@direct.stjohnhealthsystem.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/37d0fa6b-e0f7-4581-adbb-f9e2eac855e1/
• Direct secure messaging: kevingancarczyk@usoinc.medalliesdirect.net

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Oklahoma Surgical Hospital, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1487651857

  General Partnership Interest

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• McAlester Medical Services, LLC

  • Internal Medicine Physician
  • McAlester, OK
  • NPI 1154317998

  Urology

  Medicare reassignment Care Compare group NPD
• Urologic Specialists of Oklahoma Inc

  • Urology Physician
  • Tulsa, OK
  • NPI 1174546162

  AR, MO

  Medicare reassignment Care Compare group
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Mountain Grove, MO
  • NPI 1457480188
  NPD
• Oklahoma Surgical Hospital, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1487651857
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jane Phillips Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Bartlesville, OK
  • NPI 1215914254
  Care Compare affiliation
• Jane Phillips Memorial Medical Center, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Bartlesville, OK
  • NPI 1427428986
  Care Compare affiliation
• McAlester Regional Health Center Authority

  • Rural Acute Care Hospital
  • McAlester, OK
  • NPI 1316940034
  Care Compare affiliation
• Oklahoma Surgical Hospital, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1487651857
  Care Compare affiliation
• St. John Broken Arrow, Inc

  • General Acute Care Hospital
  • Broken Arrow, OK
  • NPI 1497988596
  Care Compare affiliation
• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1013983741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10901 E 48TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465830",
            "telephone_number": "918-749-8765",
            "fax_number": "918-392-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10901 E 48TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465830",
            "telephone_number": "918-749-8765",
            "fax_number": "918-392-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANCARCZYK",
        "first_name": "KEVIN",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "26830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200237950A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Foster Games, DO
• Susie J. Games, MS, LPC
• Reinaldo Gamez, BA
• Franc Gammage
• Kirk Gammell, D.D.S.
• Gautami Gandham
• Aaliyah Gann
• Alexis Gann, ATC, LAT
• Madyson Rae Gann
• Amber Gant

• Urology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Urology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.