Jyoti B Ganji, MD | |
80 B Veterans Blvd, Acoma, NM 87034 | |
(505) 552-5300 | |
(505) 552-5490 |
Full Name | Jyoti B Ganji |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 80 B Veterans Blvd, Acoma, New Mexico |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255328266 | NPI | - | NPPES |
1979627 | Medicaid | LA | |
H3451 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 06964R (Louisiana) | Primary |
208600000X | Surgery | 22011 (Kansas) | Secondary |
208600000X | Surgery | 13972 (Arizona) | Secondary |
Entity Name | Emergency Staffing Solutions Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477590974 PECOS PAC ID: 9830001650 Enrollment ID: O20050610000177 |
Entity Name | Rapid Urgent Care Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285970780 PECOS PAC ID: 0840437174 Enrollment ID: O20130506000203 |
Entity Name | Ess Hospitalist Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881967305 PECOS PAC ID: 6103085295 Enrollment ID: O20130515000072 |
Entity Name | Jena Ess Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1235544115 PECOS PAC ID: 7810116258 Enrollment ID: O20140916002675 |
Entity Name | Jena Ess Hospitalist Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1144635020 PECOS PAC ID: 5294954533 Enrollment ID: O20140918000317 |
Entity Name | Concord Medical Group Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083630610 PECOS PAC ID: 0446296818 Enrollment ID: O20140930001176 |
Entity Name | Concord North Texas Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952761173 PECOS PAC ID: 2860791688 Enrollment ID: O20170922000452 |
Entity Name | Leatherwood Emergency Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760946313 PECOS PAC ID: 0749521250 Enrollment ID: O20190410002335 |
Entity Name | South Central Physicians Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427611854 PECOS PAC ID: 6507195492 Enrollment ID: O20191022002061 |
Mailing Address | Practice Location Address |
---|---|
Jyoti B Ganji, MD Po Box 130, San Fidel, NM 87049-0130 Ph: (505) 552-5300 | Jyoti B Ganji, MD 80 B Veterans Blvd, Acoma, NM 87034 Ph: (505) 552-5300 |