NPIMap

Individual provider Active NPI

Tommie Mack Granger, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Alexandria, LA
National Provider Identifier
1124018866
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
10146R Issued in LA
Practice address
211 4TH St
Box 30163
Alexandria, LA 71301-8421
Phone
(318) 767-5878
Fax
(318) 767-5887
NPI assigned
Oct 25, 2005
Last updated
Dec 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 10146R LA Primary

Addresses

Primary practice location

211 4TH St
Box 30163
Alexandria, LA 71301-8421

Mailing address

211 4TH St
Box 30163
Alexandria, LA 71301-8421
Phone (318) 767-5878

Other identifiers 2

IdentifierTypeStateIssuer
126445OtherMPMISSISSIPPI MEDICAID
1982067MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20080912000348 LA Practitioner - Cardiac SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 8123193547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery, Vascular Surgery
Education
University of South Carolina School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Surgery of Alexandria LLCGroup PAC ID 8022045020, 2 clinicians

Practice addresses (Care Compare)

211 4TH St
Alexandria, LA 71301-8421
Phone (318) 767-5878

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.93 of 100Reported as group
Quality
95.13
Improvement activities
40
Cost
75.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)43
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)15
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10146RLAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Surgery of Alexandria ,LLC CurrentSince Jul 15, 2007 Accepting new patients

Locations

211 4th St
#30163
Alexandria, LA 71301
Phone (318) 767-5878

211 4th St
Ste 4E
Alexandria, LA 71301
Phone (318) 767-5878

301 4th St
Ste 4E
Alexandria, LA 71301
Phone (318) 443-9400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBDECA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CBDECA/Endpoint/CBDECA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1124018866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 4TH ST",
            "address_2": "BOX 30163",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018421",
            "telephone_number": "318-767-5878",
            "fax_number": "318-767-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 4TH ST",
            "address_2": "BOX 30163",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018421",
            "telephone_number": "318-767-5878",
            "fax_number": "318-767-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "TOMMIE",
        "middle_name": "MACK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "LA",
            "license": "10146R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI MEDICAID",
            "identifier": "126445",
            "state": "MP"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982067",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.