Individual provider Active NPI

Gregory Gagnon

  • Radiation Oncology Physician
  • Frederick, MD
National Provider Identifier
1407854268
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
D39954 Issued in MD
Practice address
1562 Opossumtown Pike
Frederick, MD 21702-4337
Phone
(240) 566-4500
Fax
(301) 694-5554
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X D39954 MD Primary

Addresses

Primary practice location

1562 Opossumtown Pike
Frederick, MD 21702-4337

Mailing address

111 Loder St
Hornell, NY 14843-1950

Other practice location 1

11110 Medical Campus Rd Ste 129
Hagerstown, MD 21742-6799
Phone (301) 665-4650

Other identifiers 1

IdentifierTypeStateIssuer
758511000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20100409000069 MD Practitioner - Radiation Oncology 6103952627 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Virginia School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Frederick Health Hospital IncGroup PAC ID 0446149256, shared by 8 NPIs, 127 clinicians
Gagnon Oncology LLCGroup PAC ID 5496913030, 4 clinicians

Practice addresses (Care Compare)

1562 Opossumtown Pike
Frederick, MD 21702-4920
Phone (240) 566-4500

1564 Opossumtown Pike
Frederick, MD 21702-4337

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D39954MDMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gagnon Oncology, LLC Radiation Oncology CurrentSince Feb 1, 2012 Accepting new patients
Frederick Health Hospital Inc CurrentSince Jul 1, 2016 Accepting new patients
Frederick Health Hospital Inc CurrentSince Nov 12, 2016 Accepting new patients
Gagnon Oncology, LLC Radiation Oncology CurrentSince Feb 1, 2012 Accepting new patients
Frederick Health Hospital Inc CurrentSince Jul 1, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1562 Opossumtown Pike
Frederick, MD 21702
Phone (240) 566-4500

501 W 7th St
Ste 2
Frederick, MD 21701
Phone (240) 566-4500

11110 Medical Campus Rd
Ste 129
Hagerstown, MD 21742
Phone (301) 665-4650

111 Loder St
#B
Hornell, NY 14843

Organizations & group practices 6

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 1

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1407854268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LODER ST",
            "city": "HORNELL",
            "state": "NY",
            "postal_code": "148431950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1562 OPOSSUMTOWN PIKE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024337",
            "telephone_number": "240-566-4500",
            "fax_number": "301-694-5554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11110 Medical Campus Rd Ste 129",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217426799",
            "country_code": "US",
            "telephone_number": "301-665-4650",
            "fax_number": "301-665-4648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MD",
            "license": "D39954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "758511000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.