Jeffrey Ronald Grazen, D.C.
Individual provider Active NPI Chiropractor · Lancaster, NY
NPI 1033152129 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1033152129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- X006068 (NY)
- Practice address
- 450 Central Ave
Suite 102
Lancaster, NY 14086-1262 - Phone
- (716) 683-6615
- Fax
- (716) 685-2052
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- National College of Chiropractic, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
450 Central Ave
Suite 102
Lancaster, NY 14086-1262
Phone (716) 683-6615
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110415000004 | NY | Practitioner - Chiropractic | 8729262753 | Practice locations: Lancaster, NY |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006068 | NY | MD | Ophthalmology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X006068 | NY | Yes |
Addresses
Primary practice location
450 Central Ave
Suite 102
Lancaster, NY 14086-1262
Mailing address
450 Central Ave
Suite 102
Lancaster, NY 14086-1262
Phone (716) 683-6615
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 63679 | Other | NY | GHI |
| C06068-3 | Other | NY | WORKERS COMPENSATION |
| 605089 | Other | NY | ACN |
| 16150318701 | Other | NY | PRISM HEALTH NETWORKS |
| 002259271 | Other | NY | BLUE CROSS/BLUE SHLD WNY |
| 8809354 | Other | NY | INDEPENDENT HEALTH ASSOC |
Other providers in Lancaster, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.