Individual provider Active NPI

Andrew Daniel Granas, MD

  • Family Medicine Physician
  • Waldwick, NJ
National Provider Identifier
1083607162
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA09331700 Issued in NJ
Practice address
140 Franklin Tpke
Waldwick, NJ 07463-1847
Phone
(201) 447-3603
Fax
(201) 447-5184
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA09331700 NJ Primary

Addresses

Primary practice location

140 Franklin Tpke
Waldwick, NJ 07463-1847

Mailing address

140 Franklin Tpke
Waldwick, NJ 07463-1847
Phone (201) 447-3603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20130815000430 NJ Practitioner - Family Practice 5799742102 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09331700NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC CurrentSince Sep 1, 2016 Accepting new patients
LHHN Medical, P.C. Family Medicine Past Accepting new patients
Manhattan'S Physician Group Family Medicine Past Accepting new patients

Locations

1 Valley Health Plz
Paramus, NJ 07652
Phone (201) 634-5353

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

140 Franklin Tpke
Waldwick, NJ 07463
Phone (201) 447-3603

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1083607162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 FRANKLIN TPKE",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631847",
            "telephone_number": "201-447-3603",
            "fax_number": "201-447-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 FRANKLIN TPKE",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631847",
            "telephone_number": "201-447-3603",
            "fax_number": "201-447-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANAS",
        "first_name": "ANDREW",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09331700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldwick, NJ

Sources for this page

Verify at the official NPI Registry.