Masoud Ganji, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

46629 Issued in WI

Practice address

13111 N Port Washington Rd
Mequon, WI 53097-2416

Phone

(262) 243-7300

Fax

(414) 961-3421

NPI assigned

Sep 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Pathology

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Pathologists SCGroup PAC ID 7113986563, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051
• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
• Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
• Ascension St Francis Hospital Hospital, Milwaukee, WI, CCN 520078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• North Shore Pathologists SC

  • Anatomic Pathology & Clinical Pathology Physician
  • Milwaukee, WI
  • NPI 1184703829
  Medicare reassignment Care Compare group NPD
• Columbia St. Mary's Hospital Milwaukee, Inc

  dba Ascension Columbia St Mary's Hospital Milwaukee

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482
  Medicare reassignment NPD
• Columbia St. Mary's Hospital Milwaukee Inc

  dba Ascension Columbia St Mary's Hospital Ozaukee

  • Psychiatric Hospital Unit
  • Mequon, WI
  • NPI 1417600909
  NPD
• Columbia St. Mary's Hospital Milwaukee, Inc

  dba Ascension Columbia St Mary's Hospital Milwaukee

  • Multi-Specialty Clinic/Center
  • Glendale, WI
  • NPI 1215945456
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension All Saints Hospital, Inc

  dba Ascension All Saints Hospital

  • General Acute Care Hospital
  • Racine, WI
  • NPI 1639123284
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  dba Ascension SE Wisconsin Hospital-Elmbrook Campus

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  dba Ascension SE Wisconsin Hospital-Elmbrook Campus

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation
• Ascension St Francis Hospital, Inc

  dba Ascension St Francis Hospital

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1225087190
  Care Compare affiliation
• Columbia St. Mary's Hospital Milwaukee, Inc.

  dba Ascension Columbia St Mary's Hospital Milwaukee Campus

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1871656082
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1861595910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 N LAKE DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114508",
            "telephone_number": "414-961-5362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 N PORT WASHINGTON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530972416",
            "telephone_number": "262-243-7300",
            "fax_number": "414-961-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANJI",
        "first_name": "MASOUD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "46629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34613900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Froemke
• Full Life Counseling Center
• Deborah Lee Gall
• Gary M Gallitz, LPC
• Alexandra Galmore
• Corey F Garber, LPC, SAC-T
• Taylor A Gardner, NP
• Alonzo Garza
• Amy Kathleen Gauger, PT
• Korhyn Geary

• Anatomic Pathology & Clinical Pathology Physician in Mequon, WI
• Providers in Mequon, WI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.