Active NPI
Brian Michael Granek, O.D.
- Optometrist
- Owings Mills, MD
National Provider Identifier
1124027248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TA1751
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- 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 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TA-1751 | MD | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visionary Eye Care, L.L.C. | Optometrist | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.