NPIMap

Individual provider Active NPI

Michael Bruce Gentry, D.O.

  • Obstetrics & Gynecology Physician
  • Greenwood, SC
National Provider Identifier
1730182064
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0392 Issued in SC
Practice address
107 Venture CT
Greenwood, SC 29649-8558
Phone
(864) 538-6565
Fax
(864) 538-6566
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0392 SC Primary

Addresses

Primary practice location

107 Venture CT
Greenwood, SC 29649-8558

Mailing address

107 Venture CT
Greenwood, SC 29649-8558
Phone (864) 538-6565

Other identifiers 2

IdentifierTypeStateIssuer
003926MedicaidSC
P00015070OtherSCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20050302000778 SC Practitioner - Obstetrics/Gynecology 6103879010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Ohio University, College of Osteopathic Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians

Practice addresses (Care Compare)

155 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-4865

Hospital & facility affiliations

  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071
  • Abbeville Area Medical Center Hospital, Abbeville, SC, CCN 421301

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0392SCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Self Regional Healthcare CurrentSince Nov 3, 2022 Accepting new patients
Self Regional Healthcare CurrentSince Nov 3, 2022 Accepting new patients
Self Regional Healthcare Past Accepting new patients
Action Medical Center, LLC Past Accepting new patients
Self Regional Healthcare Past Accepting new patients

Locations

102 Katie Ct
Greenwood, SC 29646
Phone (864) 227-2022

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

Interoperability endpoints

  • Direct secure messaging: mgentry127893@selfregional.direct-ci.net

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1730182064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 VENTURE CT",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296498558",
            "telephone_number": "864-538-6565",
            "fax_number": "864-538-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 VENTURE CT",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296498558",
            "telephone_number": "864-538-6565",
            "fax_number": "864-538-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "MICHAEL",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "0392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003926",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00015070",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.