Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Michael Gannon, MD

Individual provider Family Medicine Physician · NPI 1225441215

Dr. Michael Gannon, MD is a Family Practice in Martinsville, New Jersey. Qualified in 2011, 15 years ago. Practices with Practice Associates Medical Group, a 1,403-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
15
Licensed in
NJ
In the registry since
2014
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1973 Washington Valley Rd
Martinsville, NJ 08836-2053
Phone: (732) 560-9225
Fax: (732) 560-8095
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 25MA09511000 (NJ)

Record details

NPI number1225441215
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 6, 2014
Last updated in NPPESSeptember 7, 2023
Certification dateSeptember 7, 2023
Mailing addressPo Box 416457, Boston, MA 02241-2053

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Practice Associates Medical Group — 1403 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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