Individual provider Active NPI

Jeffrey M Gancas, D.C

  • Chiropractor
  • Austin, TX
National Provider Identifier
1679613848
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11241 Issued in TX
Practice address
11754 Jollyville Rd Ste 102
Austin, TX 78759-3948
Phone
(512) 345-7400
Fax
(512) 345-7405
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11241 TX Primary

Addresses

Primary practice location

11754 Jollyville Rd Ste 102
Austin, TX 78759-3948

Mailing address

11754 Jollyville Rd Ste 102
Austin, TX 78759-3948
Phone (512) 345-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091205000129 TX Practitioner - Chiropractic 9830238773 Practice locations: Austin, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12885 Research Blvd
Suite 110B
Austin, TX 78750-3223
Phone (512) 345-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jdjdj Healthcare Corp Chiropractor PastSince Feb 13, 2022 Accepting new patients

Organizations & group practices 1

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1679613848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11754 JOLLYVILLE RD STE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787593948",
            "telephone_number": "512-345-7400",
            "fax_number": "512-345-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11754 JOLLYVILLE RD STE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787593948",
            "telephone_number": "512-345-7400",
            "fax_number": "512-345-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANCAS",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.