Mirko Andrew Giaconi, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

A25678 Issued in CA

Practice address

1600 S Gaffey St
San Pedro, CA 90731-4628

Phone

(310) 548-0201

Fax

(310) 548-4492

NPI assigned

Dec 1, 2005

Last updated

Sep 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 1968

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dr Mona Shah Professional CorporationGroup PAC ID 2062548084, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• High Quality Home Health Agency, Inc Home health agency, Torrance, CA, CCN 058346
• Providence Little Co of Mary Med Ctr San Pedro Hospital, San Pedro, CA, CCN 050078
• Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351
• Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353
• Seacrest Post-Acute Care Center Nursing home, San Pedro, CA, CCN 055070

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mirko.giaconi@dmspc.eclinicaldirectplus.com

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.

• Dr Mona Shah Professional Corporation

  • Internal Medicine Physician
  • San Pedro, CA
  • NPI 1053643171

  Single Specialty

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• High Quality Home Health Agency, Inc.

  • Home Health Agency
  • Torrance, CA
  • NPI 1053471847
  Care Compare affiliation
• Providence Health System - Southern California

  dba Providence Little Company of Mary Medical Center San Pedro OBHC

  • General Acute Care Hospital
  • San Pedro, CA
  • NPI 1497241541
  Care Compare affiliation
• Providence Health System - Southern California

  dba Providence Little Company of Mary Medical Center San Pedro

  • General Acute Care Hospital
  • San Pedro, CA
  • NPI 1942247291
  Care Compare affiliation
• Providence Health System Southern California

  dba Providence Little Company of Mary Medical Center Torrance

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  Care Compare affiliation
• Seacrest Convalescent Hospital, Inc.

  • Skilled Nursing Facility
  • San Pedro, CA
  • NPI 1629146097

  Nursing home

  Care Compare affiliation
• Torrance Memorial Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1467459776
  Care Compare affiliation

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1609850700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S GAFFEY ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907314628",
            "telephone_number": "310-548-0201",
            "fax_number": "310-548-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S GAFFEY ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907314628",
            "telephone_number": "310-548-0201",
            "fax_number": "310-548-4492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1366 W 7th St",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "907323517",
            "country_code": "US",
            "telephone_number": "310-833-2461",
            "fax_number": "310-833-6432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIACONI",
        "first_name": "MIRKO",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A25678",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A25678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A256780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ghassemi Chiropractic Corp, Apc (San Pedro Chiropractic and Posture)
• Ghio and Associates Inc
• Ghio Marriage and Family Therapy Services
• Andrea Ghio, M.S.
• Dario Ghio, MFT INTERN
• Misty Dawn Gibb, EMT, BI
• Megan Gietzen, PSY.D.
• Alasha Ginn
• Julia Marie Giovenco
• Anthony William Glavis, LCSW

• Cardiovascular Disease Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.