Gary J Ganiban, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0076850 Issued in FL

Practice address

175 E Nasa Blvd Ste 201
Melbourne, FL 32901-1998

Phone

(321) 999-7456

NPI assigned

Oct 31, 2005

Last updated

Sep 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, CO2 enrollments

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 2

Specialty

Ophthalmology

Education

Drexel University College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlantic Retina ConsultantsGroup PAC ID 8820472343, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Atlantic Retina Consultants

  • Retina Specialist (Ophthalmology) Physician
  • Melbourne, FL
  • NPI 1649928490
  Medicare reassignment Care Compare group
• Colorado Mountain Medical, LLC

  • Multi-Specialty Clinic/Center
  • Avon, CO
  • NPI 1730747445
  Medicare reassignment NPD
• Colorado Mountain Medical, LLC

  • Multi-Specialty Clinic/Center
  • Frisco, CO
  • NPI 1073139267
  NPD
• Colorado Mountain Medical, LLC

  • Community/Behavioral Health Agency
  • Vail, CO
  • NPI 1326793076
  NPD
• Atlantic Eye Consultants, LLC

  dba Atlantic Wellness

  • Glaucoma Specialist (Ophthalmology) Physician
  • Melbourne, FL
  • NPI 1013665868
  NPD (past)
• Eyewearllc

  • Eyewear Supplier
  • Melbourne, FL
  • NPI 1518054956
  NPD (past)
• Colorado Mountain Medical, PC

  • Family Medicine Physician
  • Avon, CO
  • NPI 1083675102
  NPD (past)
• Vitreoretinal Institute, a Medical Corporation

  dba Vitreoretinal Institute

  • Specialist
  • Baton Rouge, LA
  • NPI 1649226580
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1306837281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E NASA BLVD STE 201",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011998",
            "telephone_number": "321-999-7456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E NASA BLVD STE 201",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011998",
            "telephone_number": "321-999-7456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 S Woods Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "329553262",
            "country_code": "US",
            "telephone_number": "321-999-7456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 N Courtenay Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Merritt Island",
            "state": "FL",
            "postal_code": "329533495",
            "country_code": "US",
            "telephone_number": "321-999-7456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Buck Creek Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "CO",
            "postal_code": "816205428",
            "country_code": "US",
            "telephone_number": "970-926-6340",
            "fax_number": "970-926-6348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5055 Babcock St NE Ste 6",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329054673",
            "country_code": "US",
            "telephone_number": "321-999-7456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANIBAN",
        "first_name": "GARY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "DR.0057603",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME0076850",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0076850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna D Gamble, MD
• Dario Gamio
• Kailash Gandhi, LMHC
• Marlena Ganem, ARNP
• Jennifer Gangi Soper, COTA/L
• Mark Magdy Fayez Garas, RPH
• Peter Garas, M.D.
• Alondra Liz Garcia Escudero
• Ayme Isabel Garcia Munoz
• Ariel F Garcia

• Ophthalmology Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.