Individual provider Active NPI

Brian Michael Granek, O.D.

  • Optometrist
  • Owings Mills, MD
National Provider Identifier
1124027248
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1751 Issued in MD
Practice address
10995 Owings Mills Boulevard
Suite 204
Owings Mills, MD 21117-1030
Phone
(410) 363-0060
Fax
(410) 363-0911
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1751 MD Primary
Corneal and Contact Management Optometrist 152WC0802X TA-1751 MD

Addresses

Primary practice location

10995 Owings Mills Boulevard
Suite 204
Owings Mills, MD 21117-1030

Mailing address

10995 Owings Mills Boulevard
Suite 204
Owings Mills, MD 21117-1030
Phone (410) 363-0060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20060620000158 MD Practitioner - OptometryPractitioner - Ophthalmology 7214949973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OptometryAlso: Ophthalmology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10995 Owings Mills Blvd
Suite 204
Owings Mills, MD 21117-1030
Phone (410) 363-0060

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA-1751MDMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionary Eye Care, L.L.C. Optometrist CurrentSince Jan 28, 2013 Accepting new patients

Locations

10995 Owings Mills Blvd
Ste 204
Owings Mills, MD 21117
Phone (410) 343-0060

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.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345161600000",
    "number": "1124027248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10995 OWINGS MILLS BOULEVARD",
            "address_2": "SUITE 204",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171030",
            "telephone_number": "410-363-0060",
            "fax_number": "410-363-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10995 OWINGS MILLS BOULEVARD",
            "address_2": "SUITE 204",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171030",
            "telephone_number": "410-363-0060",
            "fax_number": "410-363-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANEK",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2012-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1751",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MD",
            "license": "TA-1751",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.