NPIMap

Individual provider Active NPI

Jacob Everett Gantz, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Rochester, NY
National Provider Identifier
1487048955
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
601 Elmwood Ave
Box Surg
Rochester, NY 14642-0001
Phone
(585) 275-2723
NPI assigned
Mar 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

601 Elmwood Ave
Box Surg
Rochester, NY 14642-0001

Mailing address

420 Westfall Rd
Apt. 19
Rochester, NY 14620-4649
Phone (717) 357-0373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220922001097 NY Practitioner - Urology 2466796610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western New York Medical Practice PCGroup PAC ID 3870767791, 528 clinicians

Practice addresses (Care Compare)

2615 Culver Rd
Suite 100
Rochester, NY 14609-1716
Phone (585) 336-5320

Hospital & facility affiliations

  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125
  • Newark-Wayne Community Hospital Hospital, Newark, NY, CCN 330030
  • Clifton Springs Hospital and Clinic Hospital, Clifton Springs, NY, CCN 330265
  • Geneva General Hospital Hospital, Geneva, NY, CCN 330058
  • Unity Hospital Hospital, Rochester, NY, CCN 330226

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection54

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Jun 4, 2022 Accepting new patients

Locations

625 Panorama Trl
Bldg 3
Rochester, NY 14625
Phone (585) 276-9361

2615 Culver Rd
Ste 100
Rochester, NY 14609
Phone (585) 336-5320

2420 Ridgeway Ave
Rochester, NY 14626
Phone (585) 227-4000

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: jgantz@cfu.medentdirect.com

Organizations & group practices 1

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 12

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": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1487048955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 WESTFALL RD",
            "address_2": "APT. 19",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146204649",
            "telephone_number": "717-357-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX SURG",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTZ",
        "first_name": "JACOB",
        "middle_name": "EVERETT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-23",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.