Individual provider Active NPI

Peter Werner Ganter, M.D.

  • Hospitalist Physician
  • Springfield, OR
National Provider Identifier
1093792673
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD16770 Issued in OR
Practice address
Peacehealth Hospital Medicine
3377 Riverbend Drive
Springfield, OR 97477-8803
Phone
(541) 222-6389
Fax
(541) 222-6385
NPI assigned
Dec 27, 2005
Last updated
Aug 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD16770 OR
Hospitalist Physician 208M00000X MD16770 OR Primary

Addresses

Primary practice location

Peacehealth Hospital Medicine
3377 Riverbend Drive
Springfield, OR 97477-8803

Mailing address

Peacehealth Hospital Medicine
3377 Riverbend Drive
Springfield, OR 97477-8803
Phone (541) 222-6389

Other identifiers 1

IdentifierTypeStateIssuer
016308MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20040514000532 OR Practitioner - Internal Medicine 0648260323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1460 G St
Springfield, OR 97477-4197

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16770ORMDHospitalist Physician
16770ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie Physician Services LLC CurrentSince Jan 31, 2012 Accepting new patients
McKenzie Surgical Group PC Past Accepting new patients

Locations

1750 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-0333

1460 G St
Springfield, OR 97477
Phone (541) 431-0665

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1093792673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PEACEHEALTH HOSPITAL MEDICINE",
            "address_2": "3377 RIVERBEND DRIVE",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "541-222-6389",
            "fax_number": "541-222-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEACEHEALTH HOSPITAL MEDICINE",
            "address_2": "3377 RIVERBEND DRIVE",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "541-222-6389",
            "fax_number": "541-222-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTER",
        "first_name": "PETER",
        "middle_name": "WERNER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD16770",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD16770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016308",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.