Jennifer Marie Reiss Gangnier, PA-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

5601005019 Issued in MI

Practice address

2305 Genoa Business Park Dr
Suite 180
Brighton, MI 48114-7004

Phone

(810) 355-4300

Fax

(810) 355-4967

NPI assigned

Jun 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Jennifer Marie Reiss Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Phototherapy Center of Brighton PLCGroup PAC ID 7618114695, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069
• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Dermatology & Phototherapy Center of Brighton, PLC

  • Dermatology Physician
  • Brighton, MI
  • NPI 1659624591
  Medicare reassignment Care Compare group
• S L Husain Hamzavi MD PC

  • Dermatology Physician
  • Clinton TWP, MI
  • NPI 1407943962
  Medicare reassignment NPD
• Abode Integrated Medicine,PLLC

  • Neuromusculoskeletal Medicine & OMM Physician
  • Novi, MI
  • NPI 1891828885
  NPD (past)
• Hamzavi Psychiatry & Wellness Center PLLC

  • Psychiatry Physician
  • Farmington Hills, MI
  • NPI 1891188124
  NPD (past)

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

• Regents of the University of Michigan

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation
• Saint Joseph Mercy Livingston Hospital

  • General Acute Care Hospital
  • Brighton, MI
  • NPI 1093748642
  Care Compare affiliation
• St Joseph Mercy Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1265635155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43151 DALCOMA DR",
            "address_2": "SUITE 5",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386306",
            "telephone_number": "586-286-8720",
            "fax_number": "866-790-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 GENOA BUSINESS PARK DR",
            "address_2": "SUITE 180",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147004",
            "telephone_number": "810-355-4300",
            "fax_number": "810-355-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGNIER",
        "first_name": "JENNIFER",
        "middle_name": "MARIE REISS",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5601005019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "REISS",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gago Center for Fertility, PLLC
• Gago Ivf
• Laura April Gago, MD
• James Patrick Gallagher II, DO
• Amy Elizabeth Gallegos, DPT
• Jennifer Nicole Garcia, PSYD
• Lisa Garg
• Gordon Grant Garris II, PMHNP-BC
• Gary P. Ceresnie, D.P.M., P.C.
• Wyolean Crystal Gates, RN

• Dermatology Physician in Brighton, MI
• Providers in Brighton, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; 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.