Individual provider Active NPI

Glenn Peter Gwozdz, MD

  • Gastroenterology Physician
  • Hilton Head, SC
National Provider Identifier
1487785879
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
14617 Issued in SC
Practice address
35 Bill Fries Dr
BLDG F
Hilton Head, SC 29926-2730
Phone
(843) 681-6668
Fax
(843) 681-3295
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 14617 SC Primary

Addresses

Primary practice location

35 Bill Fries Dr
BLDG F
Hilton Head, SC 29926-2730

Mailing address

35 Bill Fries Dr
BLDG F
Hilton Head, SC 29926-2730
Phone (843) 681-6668

Other identifiers 1

IdentifierTypeStateIssuer
GP2995MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20110203001016 SC Practitioner - GastroenterologyPractitioner - Internal Medicine 4587621172

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Outpatient Surgery Center of Hilton Head PastSince Nov 1, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372982400000",
    "number": "1487785879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BILL FRIES DR",
            "address_2": "BLDG F",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299262730",
            "telephone_number": "843-681-6668",
            "fax_number": "843-681-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BILL FRIES DR",
            "address_2": "BLDG F",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299262730",
            "telephone_number": "843-681-6668",
            "fax_number": "843-681-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWOZDZ",
        "first_name": "GLENN",
        "middle_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2013-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "14617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2995",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head, SC

Sources for this page

Verify at the official NPI Registry.