Ellsworth Raymond Grant, M.D

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

G73084 Issued in CA

Practice address

1245 Wilshire Blvd
Suite 801
Los Angeles, CA 90017-4810

Phone

(213) 481-3948

Fax

(213) 481-1697

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Hematology/Oncology

Education

University of California, San Diego School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Oncology Institute Ca, a Professional CorporationGroup PAC ID 5698872398, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• California Hospital Medical Center la Hospital, Los Angeles, CA, CCN 050149

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ellsworth.grant@erg.direct-geniusdoc.com
• Direct secure messaging: ellsworth.grant@theoncologyinstitute.ikm.direct-ci.com

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.

• The Oncology Institute Ca, a Professional Corporation

  • Hematology & Oncology Physician
  • Downey, CA
  • NPI 1275651515
  Medicare reassignment Care Compare group NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1780877613
  Medicare reassignment
• Starling Oncology Ca, a Professional Corporation

  • Hematology & Oncology Physician
  • Las Vegas, NV
  • NPI 1225514508
  NPD
• Dignity Community Care

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1114081056
  NPD (past)
• Good Samaritan Hospital, L.P.

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1376595777
  NPD (past)
• Pih Health Good Samaritan Hospital

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1508859323
  NPD (past)
• Multicare Health System

  • General Acute Care Hospital
  • Puyallup, WA
  • NPI 1841231461
  NPD (past)

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

• Dignity Community Care

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1114081056
  Care Compare affiliation

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1043233760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "SUITE 801",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174810",
            "telephone_number": "213-481-3948",
            "fax_number": "213-481-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "SUITE 801",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174810",
            "telephone_number": "213-481-3948",
            "fax_number": "213-481-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "ELLSWORTH",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G73084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID NO.",
            "identifier": "954893061",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G730841",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G730842",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brendan Michael Grant
• Cheryl Deborah Grant, MFT
• Dario Edward Grant, ASW
• Darrylynn Nicole Grant
• Edward Gary Grant, M.D.
• James Grant, M.D.
• Jason Grant
• Justina Shanae Grant
• Lauren Alexandra Grant
• Lori Grant, CNM, WHNP-BC

• Hematology & Oncology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.