Individual provider Active NPI

Srinivasan Ganesan, MD

  • Gastroenterology Physician
  • Lorain, OH
National Provider Identifier
1124222526
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
23950 Issued in WV
Practice address
5700, Cooper Foster Park Road
Lorain, OH 44053
Phone
(440) 204-7400
NPI assigned
Jun 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 23950 WV Primary

Addresses

Primary practice location

5700, Cooper Foster Park Road
Lorain, OH 44053

Mailing address

3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Phone (440) 204-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20141222000497 GA Practitioner - Gastroenterology 8123080678 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Gastroenterology Specialists, P.CGroup PAC ID 3577500214, 6 clinicians

Practice addresses (Care Compare)

1102 Hospital Dr
Stockbridge, GA 30281-6381
Phone (770) 692-0100

4865 Bill Gardner Pkwy
Locust Grove, GA 30248-3644
Phone (770) 692-0100

Hospital & facility affiliations

  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215

Merit-based Incentive Payment System (MIPS)

Final score
86.95 of 100Reported as group
Quality
90
Improvement activities
40
Cost
69.82

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy76
Upper gastrointestinal (GI) endoscopy for acid reflux97

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
Piedmont Providers LLC CurrentSince Jul 6, 2022 Accepting new patients
Southern Gastroenterology Specialists, P.C CurrentSince Aug 1, 2014 Accepting new patients

Locations

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

4865 Bill Gardner Pkwy
Locust Grove, GA 30248
Phone (770) 692-0100

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

6555 Professional Pl
Ste C
Riverdale, GA 30274
Phone (770) 692-0100

1102 Hospital Dr
Stockbridge, GA 30281
Phone (404) 641-3345

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDFJAD
  • Direct secure messaging: srinivasan.ganesan@sgscolon.eclinicaldirectplus.com

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.

Hospital & facility affiliations 3

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1124222526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "440-204-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700, COOPER FOSTER PARK ROAD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "44053",
            "telephone_number": "440-204-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANESAN",
        "first_name": "SRINIVASAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WV",
            "license": "23950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.