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

Individual provider Obstetrics & Gynecology Physician · NPI 1164784450

Gennady G Miroshnichenko, MD is a Gynecological Oncology in Fort Worth, Texas. Qualified in 1994, 32 years ago. Practices with Acclaim Physician Group Inc, a 523-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
32
Licensed in
TX
In the registry since
2012
Specialties on file
2
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

1201 S Main St
Fort Worth, TX 76104-4804
Phone: (817) 702-6500
Fax: (817) 702-6561
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gynecologic Oncology Physician (primary) Taxonomy 207VX0201X · Licence P4595 (TX)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence P4595 (TX)

Record details

NPI number1164784450
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 12, 2012
Last updated in NPPESFebruary 1, 2021
Certification dateFebruary 1, 2021

Medicare enrollment

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

Medicare specialtyGYNECOLOGICAL ONCOLOGY
Also practisesOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Acclaim Physician Group Inc — 523 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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