NPIMap

Individual provider Active NPI

Gregory Scott Masimore, MD

  • Pain Medicine Physician
  • Greenwood, IN
National Provider Identifier
1104878982
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
01042621A Issued in IN
Practice address
730 Executive Park Dr Ste a
Greenwood, IN 46143-3213
Phone
(317) 346-7246
Fax
(317) 543-3763
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 01042621A IN
Pain Medicine Physician 208VP0000X 01042621A IN Primary

Addresses

Primary practice location

730 Executive Park Dr Ste a
Greenwood, IN 46143-3213

Mailing address

730 Executive Park Dr Ste a
Greenwood, IN 46143-3213
Phone (317) 346-7246

Other identifiers 2

IdentifierTypeStateIssuer
000000476069OtherINSIA ANTHEM
200816430MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060608000311 IN Practitioner - Pain ManagementPractitioner - Anesthesiology 2668484734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Ohio State University College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

730 Executive Park Dr
Suite a
Greenwood, IN 46143-3213
Phone (317) 346-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Spine Care Past Accepting new patients
Southern Indiana Anesthesiology Past Accepting new patients
Pain Management Center of Southern Indiana, Inc. Past Accepting new patients
Anesthesiology Consultants of Toledo, Inc Past Accepting new patients
Consultants in Anesthesiology, Inc Past Accepting new patients
Pain Management Center of Southern Indiana Pain Medicine Past Accepting new patients
Baxter County Regional Hospital, Inc Past Accepting new patients
Major Hospital Interventional Pain Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gmasimore@531.securemail.prognocis.com

Organizations & group practices 9

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1104878982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 EXECUTIVE PARK DR STE A",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461433213",
            "telephone_number": "317-346-7246",
            "fax_number": "317-543-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 EXECUTIVE PARK DR STE A",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461433213",
            "telephone_number": "317-346-7246",
            "fax_number": "317-543-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASIMORE",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "01042621A",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IN",
            "license": "01042621A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIA ANTHEM",
            "identifier": "000000476069",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200816430",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.