GENNADY G MIROSHNICHENKO MD
NPI 1164784450
Obstetrics & Gynecology - Gynecologic Oncology in Fort Worth, TX

Q: What is Gennady Miroshnichenko's NPI number?

The NPI number for Gennady Miroshnichenko is 1164784450. It was assigned to this individual provider in the NPPES registry on June 12, 2012.

Q: What is Gennady Miroshnichenko's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecologic Oncology, with taxonomy code 207VX0201X.

Active since June 12, 2012PECOS EnrolledAccepts Medicare Assignment

91.96/100

CMS Quality Rating

1201 S MAIN ST, FORT WORTH, TX 76104(817) 702-6500(817) 702-6561 Get Directions Write a Review

NPPES record last updated: February 1, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 1, 2021, Jan 9, 2019 (2 updates tracked since 2019).

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About Gennady G Miroshnichenko Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GENNADY G MIROSHNICHENKO MD (NPI 1164784450) is an individual gynecologic oncology provider in Fort Worth, Texas, licensed in Texas (P4595) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Jps Health Network, and is a graduate of Other (1994).

NPPES Registry Identity

NPI1164784450

Entity TypeIndividualMale

Primary Taxonomy207VX0201X

Provider Legal NameGENNADY G MIROSHNICHENKOCredential: MD

Location Address1201 S MAIN STFort Worth, TX 76104-4804

Mailing AddressPo Box 732973Dallas, TX 75373-2973 · (817) 702-8450

Phone(817) 702-6500

Fax(817) 702-6561

Sole ProprietorNo

Medical School CMSOtherGraduated 1994

Enumeration DateJune 12, 2012

Last NPPES UpdateFebruary 1, 20212 updates tracked since enumeration

NPPES CertifiedFebruary 1, 2021

✔ NPI 1164784450 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & Gynecology · Gynecologic OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207VX0201X

License✔ Licensed in TX · P4595

Definition

An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.

Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License P4595 (TX)

1201 S MAIN ST, Fort Worth, TX 76104

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Other Identifiers 2

Other8DM684TX · Bcbs

Medicaid307460101TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gennady G Miroshnichenko Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507015278

PECOS Enrollment IDI20121012000700

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

81 services46 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jps Health Network

Acute Care Hospitals · Fort Worth, TX

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number450039

Location1500 S Main StFort Worth, TX 76104 · Tarrant County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$171.07 typical visit price

range $56.47 – $171.07

Typical copayment $42.76 (range $14.11 – $42.76)

Most-billed visit code 99205

Established Patient

$99.68 typical visit price

range $18.18 – $139.68

Typical copayment $24.92 (range $4.54 – $34.92)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.96/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

89.78

Promoting Interoperability

100

Improvement Activities

Cost

56.81

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Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAPHNE GRULLON ROSARIO WHNP

Nurse Practitioner (Women's Health)