Individual provider Active NPI

Omar S Ganzy Sr., NP

  • Acute Care Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1710524764
Registry record updated Jun 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN157958 Issued in GA
Practice address
600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone
(850) 264-3477
NPI assigned
Dec 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN157958 GA
Acute Care Nurse Practitioner 363LA2100X RN157958 GA Primary

Addresses

Primary practice location

600 Celebrate Life Pkwy
Newnan, GA 30265-8001

Mailing address

600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone (850) 264-3477

Other identifiers 1

IdentifierTypeStateIssuer
RN157958OtherGAGEORGIA NURSING LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200204000526 GA Practitioner - Nurse Practitioner 4789010117 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical Group of Georgia LLCGroup PAC ID 4880841212, 137 clinicians

Practice addresses (Care Compare)

600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone (770) 400-6080

Hospital & facility affiliations

  • Southeastern Regional Medical Center, Inc Hospital, Newnan, GA, CCN 110233

Merit-based Incentive Payment System (MIPS)

Final score
79.74 of 100Reported as group
Quality
63.81
Promoting interoperability
100
Improvement activities
40
Cost
57.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Georgia PC CurrentSince Jan 1, 2022 Accepting new patients
City of Hope Medical Group of Georgia LLC CurrentSince Dec 23, 2019 Accepting new patients
Sound Physicians Intensivists of Georgia PC CurrentSince Feb 1, 2021 Accepting new patients

Locations

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

62742 Collections Ctr Dr
Chicago, IL 60693

Interoperability endpoints

  • Direct secure messaging: oganzy145035@cityofhope.direct-ci.com

Organizations & group practices 3

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 1

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": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624752000000",
    "number": "1710524764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CELEBRATE LIFE PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658001",
            "telephone_number": "850-264-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CELEBRATE LIFE PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658001",
            "telephone_number": "850-264-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANZY",
        "first_name": "OMAR",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-09",
        "last_updated": "2021-06-27",
        "certification_date": "2021-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN157958",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN157958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA NURSING LICENSE",
            "identifier": "RN157958",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.