Ganesha Santhyadka, MD
Individual provider Active NPI Pulmonary Disease Physician · Bangor, ME
NPI 1063443752 · NPPES record last updated Feb 3, 2022
Key facts
- NPI
- 1063443752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- MD17150 (ME)
- Practice address
- 360 Broadway
Bangor, ME 04401-3979 - Phone
- (207) 907-1155
- Fax
- (207) 907-1888
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 6
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Pulmonary Disease
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- St Joseph Hospital
Practice addresses (Care Compare)
360 Broadway
Bangor, ME 04401-3979
Hospital & facility affiliations
- St Joseph Hospital
- Northern Light Eastern Maine Medical Center
- Millinocket Regional Hospital
- Houlton Regional Hospital
- Northern Light Maine Coast Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.58 of 100
- Quality
- 83.17
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| St Joseph Hospital |
Hospital | Corporate Director (7.14%) | Jan 1, 2019 |
| St. Joseph Hospice |
Hospice | Corporate Director (7.14%) | Jan 1, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060919000217 | ME | Practitioner - Pulmonary Disease |
4789689126 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph Hospital | Current |
Accepting new patients |
Locations
900 Broadway
Bldg 4
Bangor, ME 04401
Phone (207) 907-3276
360 Broadway
#L
Bangor, ME 04401
Phone (207) 262-1703
360 Broadway
Bangor, ME 04401
Phone (207) 262-1703
600 Main St
Bldg 11
Bar Harbor, ME 04609
Phone (207) 288-1600
Interoperability endpoints
- gsanthyadka1155381@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | MD17150 | ME | |
| Pulmonary Disease Physician | 207RP1001X | MD17150 | ME | Yes |
Addresses
Primary practice location
360 Broadway
Bangor, ME 04401-3979
Mailing address
C/O St Marys Health System - Provider Enrollment
PO Box 7291
Lewiston, ME 04243-7291
Phone (207) 777-8560
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gsanthyadka613686@direct-prd.goodhelpconnections.org |
Other providers in Bangor, ME
- Gurpreet Singh Sandhu
- Kernjeet K Sandhu
- Lawrence A Sandi
- Frantisek Sandor
- Alexius Enrique Garcia Sandoval
- Laura Elizabeth Santilli
- Julia Santini
- Rachel Louise Santosuosso
- Karl Erwin Sanzenbacher
- Frank Sapere
All providers in Bangor, ME · Pulmonary Disease Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.