Individual provider Active NPI

Patrick H Ginn, M.D.

  • Family Medicine Physician
  • Waukesha, WI
National Provider Identifier
1265404586
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35890 Issued in WI
Practice address
210 NW Barstow St
Suite 201
Waukesha, WI 53188-3771
Phone
(262) 548-6907
Fax
(262) 548-3820
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35890 WI Primary

Addresses

Primary practice location

210 NW Barstow St
Suite 201
Waukesha, WI 53188-3771

Mailing address

210 NW Barstow Street
Suite 201
Waukesha, WI 53188
Phone (262) 548-6907

Other identifiers 1

IdentifierTypeStateIssuer
1265404586MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040827000587 WI Practitioner - Family Practice 0648245258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

210 NW Barstow St
Suite 201
Waukesha, WI 53188-3771
Phone (262) 555-4869

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-1000

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

Hospital & facility affiliations

  • Prohealth Home Care Home health agency, Waukesha, WI, CCN 527178
  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35890WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. Family Medicine CurrentSince Jun 27, 2016 Accepting new patients
Prohealth Medical Group Inc Family Medicine CurrentSince Jun 27, 2016 Accepting new patients

Locations

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

210 NW Barstow St
Ste 201
Waukesha, WI 53188
Phone (262) 548-6903

Interoperability endpoints

  • Direct secure messaging: pginn10127@direct.phci.org

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 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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384387200000",
    "number": "1265404586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 NW BARSTOW STREET",
            "address_2": "SUITE 201",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-548-6907",
            "fax_number": "262-548-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 NW BARSTOW ST",
            "address_2": "SUITE 201",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883771",
            "telephone_number": "262-548-6907",
            "fax_number": "262-548-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINN",
        "first_name": "PATRICK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2013-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "35890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265404586",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.