Individual provider Active NPI

John G. Gancayco, M.D.

  • Gastroenterology Physician
  • Jbsa Ft Sam Houston, TX
National Provider Identifier
1609089390
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
R1954 Issued in TX
Practice address
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234
Phone
(210) 916-2338
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101241245 VA
Internal Medicine Physician 207R00000X 0101241245 VA
Gastroenterology Physician 207RG0100X R1954 TX Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234

Mailing address

3551 Roger Brooke Dr
San Antonio, TX 78234-4504
Phone (210) 916-4367

Other identifiers 2

IdentifierTypeStateIssuer
375517503OtherTXCSHCN
375517502MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170830000507 TX Practitioner - Gastroenterology 2668758459 Reassigns benefits to 2 organizations
I20190114001660 MT Practitioner - Gastroenterology 2668758459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Uniformed Services Uhs Fe Hebert School of Med, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4370 Medical Arts Dr
Suite 295
Flower Mound, TX 75028-1742
Phone (972) 691-3777

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy104
Upper gastrointestinal (GI) endoscopy for acid reflux115

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC Gastroenterology CurrentSince Oct 1, 2017 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Dec 17, 2018 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Dec 17, 2018 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Jan 1, 2020 Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology Current Accepting new patients
University of Texas Health Science Center at San Antonio Internal Medicine Current Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Jan 1, 2020 Accepting new patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince Oct 1, 2017 Accepting new patients

Locations

2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

2230 N Reserve St
Missoula, MT 59808
Phone (406) 721-0533

2835 Fort Missoula Rd
Ste 204
Missoula, MT 59804
Phone (406) 327-3935

4370 Medical Arts Dr
Ste 295
Flower Mound, TX 75028
Phone (972) 691-3777

601 S Main St
Keller, TX 76248
Phone (817) 741-4347

12850 Toepperwein Rd
Live Oak, TX 78233
Phone 2106141234713

5425 W Spring Creek Pkwy
Ste 205
Plano, TX 75024
Phone (972) 526-5860

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

2130 NE Loop 410
Ste 250
San Antonio, TX 78217
Phone (210) 305-0420

903 W Martin St
San Antonio, TX 78207
Phone (210) 358-3400

Organizations & group practices 8

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 5

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1609089390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-916-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANCAYCO",
        "first_name": "JOHN",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101241245",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101241245",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "R1954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "375517503",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375517502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Ft Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.