Active NPI
Anna Elise Gantz
- Nurse Practitioner
- Bellevue, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 0033528
- Practice address
- 1400 W Main St Ste C
Bellevue, OH 44811-9088 - Phone
- (419) 484-5903
- NPI assigned
- Mar 22, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0033528 | OH | Primary |
Addresses
Primary practice location
1400 W Main St Ste C
Bellevue, OH 44811-9088
Mailing address
1400 W Main St Ste C
Bellevue, OH 44811-9088
Phone (419) 484-5903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230802002028 | OH | Practitioner - Nurse Practitioner | 2062873300 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pain Management Group LLC
Practice addresses (Care Compare)
1400 W Main St BLDG 1 C
Bellevue, OH 44811-9008
Phone (419) 484-5903
Hospital & facility affiliations
- Avita Ontario
- Bellevue Hospital
- Crystal Clinic Orthopaedic Center
- Galion Community Hospital
- Ohiohealth Mansfield Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75.6 of 100
- Quality
- 75.56
- Improvement activities
- 40
- Cost
- 59.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0033528 | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pain Management Group LLC | Nurse Practitioner | Current | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
3975 Embassy Pkwy
Ste 203
Akron, OH 44333
Phone (330) 668-4065
1400 W Main St
Ste C
Bellevue, OH 44811
Phone (419) 484-5903
442 W High St
Bryan, OH 43506
Phone (260) 266-8210
269 Portland Way S
Galion, OH 44833
Phone (419) 468-4841
715 Richland Mall
Ontario, OH 44906
Phone (419) 462-4547
Interoperability endpoints
- agantz1058996@direct.osumc.edu
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 17
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697673600000",
"number": "1033812920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 W MAIN ST STE C",
"city": "BELLEVUE",
"state": "OH",
"postal_code": "448119088",
"telephone_number": "419-484-5903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 W MAIN ST STE C",
"city": "BELLEVUE",
"state": "OH",
"postal_code": "448119088",
"telephone_number": "419-484-5903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANTZ",
"first_name": "ANNA",
"middle_name": "ELISE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-22",
"last_updated": "2023-10-19",
"certification_date": "2023-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "0033528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.