Dr Masoud Ganji, MD | |
13111 N Port Washington Rd, Mequon, WI 53097-2416 | |
(262) 243-7300 | |
(414) 961-3421 |
Full Name | Dr Masoud Ganji |
---|---|
Gender | Male |
Speciality | Pathology |
Experience | 29 Years |
Location | 13111 N Port Washington Rd, Mequon, Wisconsin |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861595910 | NPI | - | NPPES |
34613900 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 46629 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Ascension Columbia St Mary's Hospital Milwaukee | Milwaukee, WI | Hospital |
Ascension Se Wisconsin Hospital - St Joseph Campus | Milwaukee, WI | Hospital |
Ascension All Saints Hospital | Racine, WI | Hospital |
Ascension St Francis Hospital | Milwaukee, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
North Shore Pathologists Sc | 7113986563 | 17 |
Entity Name | Columbia St Marys Hospital Milwaukee Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023064482 PECOS PAC ID: 5890604722 Enrollment ID: O20031105000057 |
Entity Name | North Shore Pathologists Sc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184703829 PECOS PAC ID: 7113986563 Enrollment ID: O20041011000120 |
Mailing Address | Practice Location Address |
---|---|
Dr Masoud Ganji, MD 2323 N Lake Dr, Milwaukee, WI 53211-4508 Ph: (414) 961-5362 | Dr Masoud Ganji, MD 13111 N Port Washington Rd, Mequon, WI 53097-2416 Ph: (262) 243-7300 |
Susan J Riegg, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 13111 N Port Washington Road, Mequon, WI 53097 Phone: 262-243-7471 Fax: 262-243-7407 | |
James A Puerner, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 13111 N Port Washington Road, Mequon, WI 53097 Phone: 262-243-7423 Fax: 262-243-7407 |