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MR. GREGG A. GINSBURG M.D.
NPI 1184628885
Surgery in Festus, MO

Active since June 09, 2005PECOS EnrolledAccepts Medicare Assignment
1455 HIGHWAY 61, STE B, FESTUS, MO 63028(636) 931-4744(636) 931-4739 Get Directions Write a Review

NPPES record last updated: November 6, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mr. Gregg A. Ginsburg M.d. NPPES

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

MR. GREGG A. GINSBURG M.D. (NPI 1184628885) is an individual surgery provider in Festus, Missouri, licensed in Missouri (MO111296) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital Jefferson, and is a graduate of Southern Illinois University School Of Medicine (1996).

NPPES Registry Identity

NPI1184628885
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameMR. GREGG A. GINSBURGCredential: M.D.
Location Address1455 HIGHWAY 61, STE BFestus, MO 63028-4109
Mailing Address1455 Highway 61, Ste BFestus, MO 63028-4109 · (636) 931-4744 · Fax (636) 931-4739
Phone(636) 931-4744
Fax(636) 931-4739
Sole ProprietorYes
Medical School CMSSouthern Illinois University School Of MedicineGraduated 1996
Enumeration DateJune 9, 2005
Last NPPES UpdateNovember 6, 2015
✔ NPI 1184628885 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in MO · MO111296
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
1455 HIGHWAY 61, Festus, MO 63028
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Other Identifiers 4

Medicare UPING30574MO
Other020034244MO · Railroad Medicare
Medicaid208475012MO
Medicare PIN001013507MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Gregg A. Ginsburg M.d. 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 ID3274511365
PECOS Enrollment IDI20040714000020
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Gregg Ginsburg reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Iron County Hospital District
42 mi
Rural Health
301 N HIGHWAY 21
Pilot Knob, MO 63663
  • Reassigned Medicare billing, Missouri enrollment
  • Also billed through NPI 1477648178 (Missouri)
  • 53 clinicians in this Medicare group
NPI 1073799367 (573) 546-8051
Mercy Clinic Surgical Specialists, LLC
42 mi
Vascular Surgery
851 E 5TH ST, SUITE 108
Washington, MO 63090
  • Reassigned Medicare billing, Missouri enrollment
  • 168 clinicians in this Medicare group
NPI 1043530538 (636) 861-7870
Southeast Missouri Hospital Physicians, LLC
77 mi
Family Medicine
1701 LACEY ST
Cape Girardeau, MO 63701
  • Reassigned Medicare billing, Missouri enrollment
  • 470 clinicians in this Medicare group
NPI 1558311522 (573) 331-6880

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
95 services44 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
66 services62 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
35 services35 patients
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.
28 services19 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
24 services24 patients
Removal of gallbladder using an endoscope 47562
This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.
21 services21 patients

Hospital Affiliations CMS Care Compare 3

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

Mercy Hospital Jefferson

Acute Care Hospitals · Festus, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260023
Location1400 Us Highway 61Festus, MO 63028 · Jefferson County
Emergency services

Mercy Hospital Southeast

Acute Care Hospitals · Cape Girardeau, MO
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260110
Location1701 Lacey StCape Girardeau, MO 63701 · Cape Girardeau County
Emergency services Birthing friendly

Iron County Medical Center

Critical Access Hospitals · Pilot Knob, MO
OwnershipGovernment - Hospital District or Authority
CMS Certification Number261336
Location301 North Highway 21Pilot Knob, MO 63663 · Iron County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63028 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
Most-billed visit code 99213
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
75%186 patients4/55-star benchmark: 96%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%231 patients5/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
60%366 patients3/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
99%1,628 patients4/55-star benchmark: 100%
Falls: Risk Assessment
Percentage of patients aged 65 years and older with a history of falls that had a risk assessment for falls completed within 12 months
98%43 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
96%316 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
6%224 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
45%231 patients2/55-star benchmark: 95%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
50%703 patients3/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
81%42 patients4/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
84%207 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
92%224 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%224 patients1/55-star benchmark: 79%
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
74%122 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

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

GREGG A GINSBURG MD PC
Surgery
1455 HIGHWAY 61, SUITE B
FESTUS, MO 63028
Jefferson County (636) 931-4744

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gregg Ginsburg's NPI number?

The NPI number for Gregg Ginsburg is 1184628885. It was assigned to this individual provider in the NPPES registry on June 9, 2005.

Where is Gregg Ginsburg located?

Gregg Ginsburg practices at 1455 Highway 61 Ste B, Festus, MO 63028. The listed phone number is (636) 931-4744.

What is Gregg Ginsburg's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Gregg Ginsburg enrolled in Medicare?

Yes. Gregg Ginsburg is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Gregg Ginsburg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gregg Ginsburg reassigns Medicare benefits to 3 organizations: Iron County Hospital District (Pilot Knob, MO), Mercy Clinic Surgical Specialists, LLC (Washington, MO) and Southeast Missouri Hospital Physicians, LLC (Cape Girardeau, MO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gregg Ginsburg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gregg Ginsburg accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 2 other insurers list Gregg Ginsburg as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Gregg Ginsburg affiliated with any hospitals?

According to CMS data, Gregg Ginsburg is affiliated with Mercy Hospital Jefferson, Mercy Hospital Southeast and Iron County Medical Center.

When was this NPI record last updated?

The NPPES record for Gregg Ginsburg was last updated on November 6, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.