Individual provider Active NPI

Megan Reif Iacco, M.D.

  • Dermatology Physician
  • Plymouth, MI
National Provider Identifier
1740577667
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301098879 Issued in MI
Practice address
9398 N Lilley Rd
Plymouth, MI 48170-4610
Phone
(734) 344-4567
Fax
(734) 669-1104
NPI assigned
Jun 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 4301098879 MI Primary

Addresses

Primary practice location

9398 N Lilley Rd
Plymouth, MI 48170-4610

Mailing address

24 Frank Lloyd Wright Dr
J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address iacco@gangerderm.emadirect.md

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20150612001204 MI Practitioner - Dermatology 7810208147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Michigan Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laura K Ganger MD PCGroup PAC ID 0143472373, 8 clinicians

Practice addresses (Care Compare)

49200 Wixom Tech Dr
Ganger Dermatology
Wixom, MI 48393-3560
Phone (734) 344-4567

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

Merit-based Incentive Payment System (MIPS)

Final score
92.18 of 100Reported as group
Quality
89.06
Promoting interoperability
94
Improvement activities
40
Cost
89.89

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions466
Skin biopsy154

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301098879MIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laura K Ganger, M.D. P.C. Dermatology CurrentSince Sep 3, 2017 Accepting new patients

Locations

7397 Solutions Ctr
Chicago, IL 60677

1979 S Huron Pkwy
Ann Arbor, MI 48104
Phone (734) 344-4567

9398 N Lilley Rd
Plymouth, MI 48170
Phone (734) 254-0453

650 S Main St
Plymouth, MI 48170
Phone (734) 344-4567

49200 Wixom Tech Dr
Wixom, MI 48393
Phone (734) 344-4567

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.

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": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1740577667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9398 N LILLEY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704610",
            "telephone_number": "734-344-4567",
            "fax_number": "734-669-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACCO",
        "first_name": "MEGAN",
        "middle_name": "REIF",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301098879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iacco@gangerderm.emadirect.md",
            "affiliation": "N",
            "address_1": "9398 N Lilley Rd",
            "city": "Plymouth",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481704610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.