NPIMap

Individual provider Active NPI

Bradford D Granger, M.D.

  • Internal Medicine Physician
  • Lancaster, PA
National Provider Identifier
1083603526
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD421982 Issued in PA
Practice address
2110 Harrisburg Pike
Suite 100
Lancaster, PA 17604-3200
Phone
(717) 544-3191
Fax
(717) 544-3637
NPI assigned
Oct 18, 2005
Last updated
Sep 5, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD421982 PA Primary

Addresses

Primary practice location

2110 Harrisburg Pike
Suite 100
Lancaster, PA 17604-3200

Mailing address

2110 Harrisburg Pike
Suite 100
Lancaster, PA 17604-3200
Phone (717) 544-3191

Other identifiers 10

IdentifierTypeStateIssuer
0019597180001MedicaidPA
1441611OtherPAHIGHMARK BLUE SHIELD
1531655OtherPAGATEWAY HEALTH PLAN
P004950OtherPAGATEWAY HEALTH PLAN
1130420OtherPAAETNA HMO
7684425OtherPAAETNA NON-HMO
83116 S1QAOtherPAGEISINGER HEALTH PLAN
50012584OtherPACAPITAL BLUE CROSS
H67285OtherPAHEALTH ASSURANCE
P00065632OtherPARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100121000103 PA Practitioner - Internal Medicine 8729120373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Pittsburgh School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

2110 Harrisburg Pike
Suite 100
Lancaster, PA 17601-2644
Phone (717) 544-3191

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD421982PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group Internal Medicine CurrentSince Aug 1, 2003 Accepting new patients
Lancaster General Medical Group CurrentSince Aug 1, 2003 Accepting new patients
Lancaster General Medical Group Current Accepting new patients
Lancaster General Medical Group Past Accepting new patients

Locations

2110 Harrisburg Pike
Ste 100
Lancaster, PA 17601
Phone (717) 544-3191

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

Interoperability endpoints

  • Direct secure messaging: bgranger923@direct-lghealth.org

Organizations & group practices 4

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1083603526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 HARRISBURG PIKE",
            "address_2": "SUITE 100",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176043200",
            "telephone_number": "717-544-3191",
            "fax_number": "717-544-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 HARRISBURG PIKE",
            "address_2": "SUITE 100",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176043200",
            "telephone_number": "717-544-3191",
            "fax_number": "717-544-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "BRADFORD",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD421982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019597180001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1441611",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1531655",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "P004950",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1130420",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO",
            "identifier": "7684425",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "83116 S1QA",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50012584",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ASSURANCE",
            "identifier": "H67285",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00065632",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.