Individual provider Active NPI

Adrienne Ann Grant, D.O.

  • General Practice Physician
  • Long Beach, CA
National Provider Identifier
1063571834
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
20A7285 Issued in CA
Practice address
1777 N Bellflower Blvd Ste 107
Long Beach, CA 90815-4019
Phone
(562) 597-6020
Fax
(562) 597-6024
NPI assigned
Dec 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 20A7285 CA Primary

Addresses

Primary practice location

1777 N Bellflower Blvd Ste 107
Long Beach, CA 90815-4019

Mailing address

1777 N Bellflower Blvd Ste 107
Long Beach, CA 90815-4019
Phone (562) 597-6020

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070718000764 CA Practitioner - General PracticePractitioner - Osteopathic Manipulative Medicine 5597866764 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Osteopathic Manipulative Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1400 Colorado Blvd
A
Eagle Rock, CA 90041-2321
Phone (323) 999-2250

710 S Central Ave
Suite 310
Glendale, CA 91204-4641
Phone (818) 396-5190

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A7285CAMDGeneral Practice Physician
7285CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jaga Medical Group Inc General Practice CurrentSince Aug 22, 2016 Accepting new patients
Lifespring Medical Group CurrentSince Feb 1, 2025 Accepting new patients
Oceanpointe Incorporated General Practice PastSince Feb 27, 2007 Accepting new patients

Locations

710 S Central Ave
Ste 310
Glendale, CA 91204
Phone (747) 215-6350

1400 Colorado Blvd
Apt A
Los Angeles, CA 90041
Phone (323) 999-2250

Organizations & group practices 3

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

Hospital & facility affiliations 6

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063571834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 N BELLFLOWER BLVD STE 107",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154019",
            "telephone_number": "562-597-6020",
            "fax_number": "562-597-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 N BELLFLOWER BLVD STE 107",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154019",
            "telephone_number": "562-597-6020",
            "fax_number": "562-597-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "ADRIENNE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A7285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.