Individual provider Active NPI

Richard A Gan, MD

  • Neurology Physician
  • Edison, NJ
National Provider Identifier
1063588481
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA06475900 Issued in NJ
Practice address
34-36 Progress St
B-3
Edison, NJ 08820-1197
Phone
(908) 757-6633
Fax
(908) 757-3912
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 25MA06475900 NJ Primary

Addresses

Primary practice location

34-36 Progress St
B-3
Edison, NJ 08820-1197

Mailing address

34-36 Progress St
B-3
Edison, NJ 08820-1197
Phone (908) 757-6633

Other identifiers 1

IdentifierTypeStateIssuer
7039301MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110128000896 NJ Practitioner - Neurology 8921287467 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
HMH Hospitals Corporation CurrentSince Apr 1, 2022 Accepting new patients
HMH Hospitals Corporation CurrentSince Apr 1, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
Community Hospital Group Inc Current Accepting new patients
Community Hospital Group, Inc. Neurology CurrentSince Oct 21, 2021 Accepting new patients
Community Hospital Group, Inc Past Accepting new patients
Community Hospital Group, Inc Past Accepting new patients

Locations

34-36 Progress St
Ste B3
Edison, NJ 08820
Phone (201) 738-9750

65 James St
Lot G
Edison, NJ 08820
Phone (732) 321-7487

65 James St
Edison, NJ 08820
Phone (732) 321-7010

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

865 Stone St
Rahway, NJ 07065
Phone (732) 381-4000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
  • Direct secure messaging: richard.gan@direct.hackensackmeridian.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1063588481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34-36 PROGRESS ST",
            "address_2": "B-3",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201197",
            "telephone_number": "908-757-6633",
            "fax_number": "908-757-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34-36 PROGRESS ST",
            "address_2": "B-3",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201197",
            "telephone_number": "908-757-6633",
            "fax_number": "908-757-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAN",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA06475900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7039301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.