Individual provider Active NPI

Octavia B Graur, MD PHD

  • Anatomic Pathology & Clinical Pathology Physician
  • Muskegon, MI
National Provider Identifier
1033200720
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301081261 Issued in MI
Practice address
1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone
(231) 728-5758
Fax
(231) 728-5636
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301081261 MI Primary

Addresses

Primary practice location

1500 E Sherman Blvd
Muskegon, MI 49444-1849

Mailing address

PO Box 26
Muskegon, MI 49443-0026
Phone (231) 728-5758

Other identifiers 2

IdentifierTypeStateIssuer
2099460MedicaidMI
4506402MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address graurmdo@trinity-health.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090122000532 MI Practitioner - Pathology 5395809198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westshore Diagnostics, PCGroup PAC ID 4789748906, 6 clinicians

Practice addresses (Care Compare)

1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone (231) 728-5758

Hospital & facility affiliations

  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
  • Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174
  • Mercy Health Lakeshore Campus Hospital, Shelby, MI, CCN 231320
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Westshore Diagnostics, PC CurrentSince Jan 1, 2009 Accepting new patients

Locations

10 Little Brook Rd
West Wareham, MA 02576

1700 Clinton St
Muskegon, MI 49442
Phone (231) 726-3511

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

1774 Peck St
Muskegon, MI 49441
Phone (231) 722-6768

3104 Henry St
Norton Shores, MI 49441

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1033200720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494430026",
            "telephone_number": "231-728-5758",
            "fax_number": "231-728-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441849",
            "telephone_number": "231-728-5758",
            "fax_number": "231-728-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAUR",
        "first_name": "OCTAVIA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301081261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2099460",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4506402",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "graurmdo@trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Trinity Muskegon MI Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1500 E Sherman Blvd",
            "city": "Muskegon",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.