NPIMap

Individual provider Active NPI

Gina Marie Campagna, M.D.

  • Diagnostic Radiology Physician
  • Odessa, TX
National Provider Identifier
1568464329
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
L9639 Issued in TX
Practice address
500 W 4TH St
Odessa, TX 79761-5001
Phone
(432) 640-1273
Fax
(432) 640-4606
NPI assigned
Aug 11, 2005
Last updated
Jan 10, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X L9639 TX Primary

Addresses

Primary practice location

500 W 4TH St
Odessa, TX 79761-5001

Mailing address

PO Box 2129
Odessa, TX 79760-2129
Phone (432) 640-2401

Other identifiers 1

IdentifierTypeStateIssuer
167002803MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040910000247 TX Practitioner - Diagnostic Radiology 7810896016 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rutgers New Jersey Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Imaging PAGroup PAC ID 4688564586, 17 clinicians

Practice addresses (Care Compare)

400 Rosalind Redfern Grover Pkwy
Midland, TX 79701-5846
Phone (432) 221-4911

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.6 of 100Reported as group
Quality
86.59
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MCH Professional Care Hospital Based Diagnostic Radiology CurrentSince Oct 1, 2011 Accepting new patients
Southwest Medical Imaging PA Diagnostic Radiology CurrentSince Jun 1, 2017 Accepting new patients
Hudson Valley Radiology Associates PLLC Diagnostic Radiology Past Accepting new patients
Ector County Hospital District Past Accepting new patients
Permian Basin Radiology, LLC Diagnostic Radiology Past Accepting new patients

Locations

400 Rosalind Redfern Grover Pkwy
Midland, TX 79701
Phone (432) 221-4850

4214 Andrews Hwy
Ste 103
Midland, TX 79703
Phone (432) 221-1301

5615 Deauville
Ste 100
Midland, TX 79706
Phone (432) 682-9729

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1568464329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797602129",
            "telephone_number": "432-640-2401",
            "fax_number": "432-640-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-1273",
            "fax_number": "432-640-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPAGNA",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "L9639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167002803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.