NPIMap

Individual provider Active NPI

Jacques Ganem, MD

  • Urology Physician
  • Charlotte, NC
National Provider Identifier
1407896202
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2254900 Issued in NC
Practice address
1718 E 4TH St
Suite 807
Charlotte, NC 28204-3260
Phone
(704) 375-5755
Fax
(704) 335-3380
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9800540 NC
Urology Physician 208800000X 2254900 NC Primary

Addresses

Primary practice location

1718 E 4TH St
Suite 807
Charlotte, NC 28204-3260

Mailing address

1718 E 4TH St
Suite 807
Charlotte, NC 28204-3260
Phone (704) 375-5755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070228000717 NC Practitioner - Urology 2668574278 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of North Carolina at Chapel Hill School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stone Institute of the Carolinas LLCGroup PAC ID 3173412533, 29 clinicians
Urology Specialists of the Carolinas PLLCGroup PAC ID 0648178020, 78 clinicians

Practice addresses (Care Compare)

215 S Main St
Suite 201
Davidson, NC 28036-8039
Phone (704) 896-2120

325 Hawthorne LN
Suite 300
Charlotte, NC 28204-2433
Phone (704) 372-5180

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Atrium Health Pineville Hospital, Charlotte, NC, CCN 340098
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Carolinas Rehabilitation Inpatient rehabilitation facility, Charlotte, NC, CCN 343026

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9800540NCMDSpecialist
2254900NCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Jan 1, 2007 Accepting new patients
Urology Specialists of the Carolinas PLLC Urology CurrentSince Jan 1, 2012 Accepting new patients
Stone Institute of the Carolinas LLC Urology CurrentSince Jan 29, 2001 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Jan 1, 2007 Accepting new patients
Urology Specialists of the Carolinas PastSince May 26, 2024 Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

325 Hawthorne Ln
Ste 300
Charlotte, NC 28204
Phone (704) 372-5180

1718 E 4th St
Ste 807
Charlotte, NC 28204
Phone (704) 375-5755

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

101 E Wt Harris Blvd
Ste 5201
Charlotte, NC 28262
Phone (704) 547-1495

Interoperability endpoints

  • Direct secure messaging: jganem78502@direct.novanthealth.org
  • Direct secure messaging: jganem@urologyspecialistsnc.emadirect.md

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1407896202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST",
            "address_2": "SUITE 807",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043260",
            "telephone_number": "704-375-5755",
            "fax_number": "704-335-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST",
            "address_2": "SUITE 807",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043260",
            "telephone_number": "704-375-5755",
            "fax_number": "704-335-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANEM",
        "first_name": "JACQUES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "9800540",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2254900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.