Gayathri Ganesh, PA-C
Physician Assistant in Chicago, IL. Individual provider (NPI-1).
NPI number1801547120
StatusActive
Last updated in NPPESJan 30, 2024
Details
- NPI
- 1801547120
- Entity type
- Individual (NPI-1)
- Name
- Gayathri Ganesh
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 18, 2022
- Certification date
- Jan 30, 2024
- Last updated
- Jan 30, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085009660 | IL | Yes |
| 207R00000X | Internal Medicine | 25MP00678000 | NJ |
Practice location
333 N Michigan Ave Ste 1400Chicago, IL 60601-4011
Phone 312-815-9660
Mailing address
333 N Michigan Ave Ste 1400Chicago, IL 60601-4011
Phone 312-815-9660
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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