Glenn Ross Gangi, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

17068 Issued in SC

Practice address

2835 E Hwy 76
Ste 3
Mullins, SC 29574

Phone

(843) 423-0230

Fax

(843) 423-0802

NPI assigned

Mar 7, 2006

Last updated

Dec 29, 2016By the provider in NPPES

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 11

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

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 2

Specialty

Urology

Education

Albert Einstein College of Medicine of Yeshiva University, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLeod Loris Hospital Hospital, Loris, SC, CCN 420105
• McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051
• Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085
• McLeod Medical Center - Dillon Hospital, Dillon, SC, CCN 420005

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ggangi28699@directmcleodehealth.org

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.

• McLeod Physician Associates II

  • Family Medicine Physician
  • Florence, SC
  • NPI 1801990494

  Urology

  Medicare reassignment Care Compare group NPD
• Atlantic Urology Clinics LLC

  • Urology Physician
  • Little River, SC
  • NPI 1447293790
  Medicare reassignment NPD
• Adult & Pediatric Urology Center of the Carolinas PA

  • Urology Physician
  • Mullins, SC
  • NPI 1528018264
  Authorized official Same address or phone
• Atlantic Urology Clinics LLC

  dba Coastal Comprehensive Women's Center

  • Gynecologic Oncology Physician
  • Myrtle Beach, SC
  • NPI 1881018596
  NPD
• McLeod Physician Associates II

  dba McLeod Orthopaedics - Florence

  • Orthopaedic Surgery Physician
  • Florence, SC
  • NPI 1922555739
  NPD
• McLeod Physician Associates II

  dba McLeod Nephrology Associates

  • Nephrology Physician
  • Florence, SC
  • NPI 1437541901
  NPD (past)

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

• Grand Strand Regional Medical Center LLC

  dba Grand Strand Medical Center

  • General Acute Care Hospital
  • Myrlte Beach, SC
  • NPI 1083668669
  Care Compare affiliation
• McLeod Loris Seacoast Hospital

  dba Loris Community Hospital

  • General Acute Care Hospital
  • Loris, SC
  • NPI 1306123344
  Care Compare affiliation
• McLeod Medical Center-Dillon

  • General Acute Care Hospital
  • Dillon, SC
  • NPI 1598746141
  Care Compare affiliation
• McLeod Regional Medical Center of the Pee Dee, Inc.

  • General Acute Care Hospital
  • Florence, SC
  • NPI 1699756221
  Care Compare affiliation

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1932176195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "MANAGED CARE DEPT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 E HWY 76",
            "address_2": "STE 3",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "29574",
            "telephone_number": "843-423-0230",
            "fax_number": "843-423-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGI",
        "first_name": "GLENN",
        "middle_name": "ROSS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "17068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T10681",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00360556",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4241328",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE",
            "identifier": "2199551A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7905534",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4522",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0930136",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "80023027",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G1521",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON HEALTH PLAN",
            "identifier": "000000206904",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "776932",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasminn Foxworth
• Michael Bruce Frederickson, R.PH.
• Felix Fredrick
• Iesha C Freitas
• Sandra Gainey, BACHELORS
• Jonathan Gardner, DMD
• James S Garner IV, MD
• Amy Paige Gerald, RN
• Elisa L Gibbs
• Alicia B Gilbert, RN

• Urology Physician in Mullins, SC
• Providers in Mullins, SC by specialty
• Urology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.