Kevin Michael Grant, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 13262 TPA Issued in CA

Practice address

3140 Bear St
Costa Mesa, CA 92626-2964

Phone

(714) 557-2020

NPI assigned

May 10, 2008

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

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of California - School of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grant Optometric Group IncGroup PAC ID 1658662945, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grant Optometric Group Inc.

  • Optometrist
  • Costa Mesa, CA
  • NPI 1316395775
  Medicare reassignment Care Compare group NPD Authorized official
• Ziggy'S Optometry Corporation

  • Optometrist
  • Newport Beach, CA
  • NPI 1629223706
  NPD

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

{
    "created_epoch": "1210377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210377600000",
    "number": "1043487929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 BEAR ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 BEAR ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262964",
            "telephone_number": "714-557-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-10",
        "last_updated": "2008-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 13262 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Adrian Gracida, LVN
• Svetlana Sergeyevna Gradoni, LCSW
• Ryan Paige Graham
• Virginia P Grams
• Grant Optometric Group Inc.
• Michael Anthony Grap
• Noah Douglas Grassie I
• Merry Ann Grasska, N.P.
• Derrick Vincent Grassmann
• Armond Jamell Larue Gray

• Optometrist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2008; 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.