Individual provider Active NPI

Robert Ginnebaugh

  • Anesthesiology Physician
  • Clinton Township, MI
National Provider Identifier
1760725675
Registry record updated Nov 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301115455 Issued in MI
Practice address
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone
(586) 263-2300
NPI assigned
Mar 28, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 265229 MA
Student in an Organized Health Care Education/Training Program 390200000X MA
Anesthesiology Physician 207L00000X 4301115455 MI Primary

Addresses

Primary practice location

15855 19 Mile Rd
Clinton Township, MI 48038-3504

Mailing address

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

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
I20180904002860 MI Practitioner - Anesthesiology 8729222112 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern District Anesthesiology PLLCGroup PAC ID 6507195419, 40 clinicians
Macomb Anesthesia PCGroup PAC ID 2860486388, 11 clinicians

Practice addresses (Care Compare)

1349 S Rochester Rd
250 Orthopaedic Surgical Institute
Rochester Hills, MI 48307-3186
Phone (248) 601-0040

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2373

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
46.38 of 100Reported as group
Quality
35.05
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265229MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern District Anesthesiology PLLC Anesthesiology CurrentSince Aug 16, 2019 Accepting new patients
Macomb Anesthesia, PC Anesthesiology CurrentSince Aug 1, 2018 Accepting new patients

Locations

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

1349 S Rochester Rd
Ste 250
Rochester Hills, MI 48307
Phone (248) 601-0040

Interoperability endpoints

  • Direct secure messaging: rginnebaugh538804@direct.hfhs.org

Organizations & group practices 2

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 2

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": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541203200000",
    "number": "1760725675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINNEBAUGH",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-28",
        "last_updated": "2018-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "265229",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301115455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.