Andrew C Gin, PLLC
Organization Active NPI Medical Specialty Clinic/Center · Oklahoma City, OK
NPI 1497909501 · NPPES record last updated Oct 26, 2012
Key facts
- NPI
- 1497909501
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medical Specialty Clinic/Center 261QM2500X
- License
- 11482 (OK)
- Legal business name
- ANDREW C GIN, PLLC
- Practice address
- 1211 N Shartel Ave
Ste 600
Oklahoma City, OK 73103-2400 - Phone
- (405) 682-9955
- Fax
- (405) 682-9979
- NPI assigned
- Nov 17, 2008
- Organization subpart
- No
Authorized official
- Name
- Andrew C Gin, M.D.
- Title
- Owner
- Phone
- (405) 682-9955
Practitioners 1
-
Andrew C Gin, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090430000379 | OK | Part B Supplier - Clinic/Group Practice | 9830247816 |
Receives reassigned benefits from 1 practitioner Practice locations: Oklahoma City, OK |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | 11482 | OK | Yes |
Addresses
Primary practice location
1211 N Shartel Ave
Ste 600
Oklahoma City, OK 73103-2400
Mailing address
1211 N Shartel Ave
Ste 600
Oklahoma City, OK 73103-2400
Phone (405) 682-9955
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336110717 | Other | OK | NPI INDIVIDUAL |
| 100252780B | Medicaid | OK | |
| P00281427 | Other | OK | RR MEDICARE |
Other providers in Oklahoma City, OK
- Stephen A Andrade
- Vilman Andre
- Andrea Larabee, PHD, PLLC
- Andrea Vadnais Counseling, LLC
- Mitchell Jeffrey Andrea
- Andrew F Frost MD Inc
- Jacob Andrew
- Tia Andrew
- Ashley Andrews
- Benjamin Andrews
All providers in Oklahoma City, OK · Medical Specialty Clinic/Center in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.