Individual provider Active NPI

George Ganson

  • Diagnostic Radiology Physician
  • Brockton, MA
National Provider Identifier
1942490115
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
263157 Issued in MA
Practice address
110 Liberty St
Brockton, MA 02301-5674
Phone
(508) 565-3275
NPI assigned
Jul 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD445498 PA
Diagnostic Radiology Physician 2085R0202X 263157 MA Primary

Addresses

Primary practice location

110 Liberty St
Brockton, MA 02301-5674

Mailing address

680 Centre St
Brockton, MA 02302-3308
Phone (508) 894-0400

Other practice location 1

500 University Dr
Hershey, PA 17033-2360
Phone (800) 243-1455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20151008001715 MA Practitioner - Diagnostic Radiology 9931365632 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Boston University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shields Signature Imaging, LLC CurrentSince Feb 19, 2020 Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 5, 2015 Accepting new patients
Signature Healthcare Medical Group Inc CurrentSince Jun 1, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Aug 17, 2015 Accepting new patients

Locations

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

110 Liberty St
Brockton, MA 02301

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

851 Middle St
Ste 2100
Fall River, MA 02721
Phone (508) 235-5445

531 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 991-2255

15 Roche Brothers Way
Ste 200
North Easton, MA 02356
Phone (401) 490-1939

Interoperability endpoints

  • Direct secure messaging: george.ganson@direct.signature.masshiway.net

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": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1942490115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-894-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015674",
            "telephone_number": "508-565-3275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "fax_number": "717-531-5596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANSON",
        "first_name": "GEORGE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD445498",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "263157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.