Individual provider Active NPI

Pramod Reddy Ganta, MD

  • Hematology & Oncology Physician
  • Anderson, SC
National Provider Identifier
1841236395
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
35066 Issued in SC
Practice address
2508 N Main St Ste G
Anderson, SC 29621
Phone
(864) 540-8430
Fax
(866) 421-1896
NPI assigned
Jun 22, 2006
Last updated
Aug 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 19517 MS
Hematology & Oncology Physician 207RH0003X 35066 SC Primary
Hospitalist Physician 208M00000X 19517 MS

Addresses

Primary practice location

2508 N Main St Ste G
Anderson, SC 29621

Mailing address

2508 N Main St Ste G
Anderson, SC 29621-3266
Phone (864) 540-8430

Other practice location 1

1403 E Greenville St
E
Anderson, SC 29621-2049
Phone (864) 540-8430

Other identifiers 4

IdentifierTypeStateIssuer
P00417392OtherMSRAILROAD MEDICARE
7460782OtherMSAETNA
1124249MedicaidLA
07502764MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20121008000669 SC Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - Hematology 9133181027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Hematology, Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3617 Hwy 81 N
Anderson, SC 29621-4421
Phone (864) 540-8430

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ms Methodist Hospital & Rehabilitation Center Past Accepting new patients
Mississippi Methodist Hospital & Rehabilitation Center, Inc. Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1841236395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 N MAIN ST STE G",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213266",
            "telephone_number": "864-540-8430",
            "fax_number": "866-421-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 N MAIN ST STE G",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "29621",
            "telephone_number": "864-540-8430",
            "fax_number": "866-421-1896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1403 E Greenville St",
            "address_2": "E",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296212049",
            "country_code": "US",
            "telephone_number": "864-540-8430",
            "fax_number": "866-421-1896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANTA",
        "first_name": "PRAMOD",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "19517",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "SC",
            "license": "35066",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "19517",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00417392",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7460782",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124249",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07502764",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.