Individual provider Active NPI

Joseph Dillon Gragnano

  • Physical Therapist
  • Boise, ID
National Provider Identifier
1013660562
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1520 W State St Ste 210
Boise, ID 83702-4026
Phone
(208) 336-8433
NPI assigned
Feb 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1520 W State St Ste 210
Boise, ID 83702-4026

Mailing address

16083 SW Upper Boones Ferry Rd Ste 300
Portland, OR 97224-7736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220309002610 ID Practitioner - Physical Therapist in Private Practice 3476948407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Associates IncGroup PAC ID 0042116279, 319 clinicians

Practice addresses (Care Compare)

1520 W State St
Suite 210
Boise, ID 83702-4085
Phone (208) 336-8433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Associates Inc Physical Therapist Current Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Feb 15, 2022 Accepting new patients
Therapeutic Associates Inc Physical Therapist CurrentSince Feb 15, 2022 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

390 E Parkcenter Blvd
Ste 130
Boise, ID 83706
Phone (208) 433-9211

1520 W State St
Ste 210
Boise, ID 83702
Phone (208) 336-8433

960 S Broadway Ave
Ste 200
Boise, ID 83706
Phone (208) 433-9211

3645 E Overland Rd
Meridian, ID 83642
Phone (208) 703-4950

16083 SW Upper Boones Ferry Rd
Ste 300
Tigard, OR 97224
Phone (503) 443-6153

Interoperability endpoints

  • Direct secure messaging: joseph.gragnano.1@31414.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1013660562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 W STATE ST STE 210",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024026",
            "telephone_number": "208-336-8433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAGNANO",
        "first_name": "JOSEPH",
        "middle_name": "DILLON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.