Individual provider Active NPI

Brianna Nichole Grant

  • Physician Assistant
  • Santa Ana, CA
National Provider Identifier
1093332090
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1093332090 Issued in FL
Practice address
210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone
(888) 959-5912
NPI assigned
Jun 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 1093332090 FL Primary

Addresses

Primary practice location

210 N Tustin Ave
Santa Ana, CA 92705-3807

Mailing address

4675 Linton Blvd Ste 102
Delray Beach, FL 33445-6615
Phone (954) 839-5923

Other practice location 1

520 SW 63rd Ter
Margate, FL 33068-1738
Phone (954) 839-5923

Other practice location 2

4675 Linton Blvd Ste 102
Delray Beach, FL 33445-6615
Phone (561) 501-7445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201204001286 FL Practitioner - Physician Assistant 7113338666 Reassigns benefits to 1 organization
I20231221002682 CA Practitioner - Physician Assistant 7113338666

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurosurgical Consultants of South Florida LLCGroup PAC ID 9931091204, 9 clinicians

Practice addresses (Care Compare)

1309 N Flagler Dr
Good Samaritan Medical Center
West Palm Beach, FL 33401-3406
Phone (561) 655-5511

4675 Linton Blvd
Suite 102
Delray Beach, FL 33445-6615
Phone (561) 501-7445

5352 Linton Blvd
Delray Beach, FL 33484-6514
Phone (561) 498-4440

Hospital & facility affiliations

  • Delray Medical Center Hospital, Delray Beach, FL, CCN 100258
  • Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61260CAMDGeneral Practice Dentistry
1093332090FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgical Consultants of South Florida, LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

800 Meadows Rd
Boca Raton, FL 33486
Phone (561) 395-7100

4675 Linton Blvd
Ste 102
Delray Beach, FL 33445
Phone (561) 496-2525

5352 Linton Blvd
Delray Beach, FL 33484
Phone (561) 495-3166

3365 Burns Rd
Ste 208
Palm Beach Gardens, FL 33410
Phone (443) 782-7179

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1093332090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4675 LINTON BLVD STE 102",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334456615",
            "telephone_number": "954-839-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "888-959-5912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 SW 63rd Ter",
            "address_purpose": "LOCATION",
            "city": "Margate",
            "state": "FL",
            "postal_code": "330681738",
            "country_code": "US",
            "telephone_number": "954-839-5923",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4675 Linton Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334456615",
            "country_code": "US",
            "telephone_number": "561-501-7445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "BRIANNA",
        "middle_name": "NICHOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "1093332090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.