Rodolfo Bautista Ganzon, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

200100871 Issued in NC

Practice address

1500 Matthews Township Pkwy
Matthews, NC 28105-4656

Phone

(704) 384-9740

Fax

(704) 384-9565

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
• Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
• Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Novant Health Matthews Medical Center LLC

  • Specialist
  • Matthews, NC
  • NPI 1184782419
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Hospitalist Physician
  • Winston Salem, NC
  • NPI 1740903566
  NPD
• Dove Internal Medicine

  • Internal Medicine Physician
  • Monroe, NC
  • NPI 1992735047
  NPD (past)
• Memorial Hospital Inc.

  • Rural Health Clinic/Center
  • Manchester, KY
  • NPI 1255471827

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Novant Health Ballantyne Medical Center LLC

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1740998020
  Care Compare affiliation
• Novant Health Matthews Medical Center LLC

  • General Acute Care Hospital
  • Matthews, NC
  • NPI 1063463156
  Care Compare affiliation
• The Presbyterian Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1396798591

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1497708838
  Care Compare affiliation
• The Presbyterian Hospital

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1881647204
  Care Compare affiliation
• The Presbyterian Hospital

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1891871901

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1245259365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-9740",
            "fax_number": "704-384-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MATTHEWS TOWNSHIP PKWY",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054656",
            "telephone_number": "704-384-9740",
            "fax_number": "704-384-9565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawthorne Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042515",
            "country_code": "US",
            "telephone_number": "704-384-5416",
            "fax_number": "704-384-5992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANZON",
        "first_name": "RODOLFO",
        "middle_name": "BAUTISTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200100871",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "200100871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS NC",
            "identifier": "12994",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110236348",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00878",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912994",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rganzon15264@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "200 Hawthorne Ln",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsey Gaines, DPT
• Peyton Noelle Galbreath, OT
• Brittany Allison Galyan, BCBA
• Ganglani Matthews PLLC
• Meghan Sue Ganio Molinari, RD
• Amy Garcia
• Sheri Marie Garcia, PT
• John E. Gardella, MD
• Lygia Yvette Garrido
• Abdul Karim Garuba, MD

• Hospitalist Physician in Matthews, NC
• Providers in Matthews, NC by specialty
• Hospitalist Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.