Individual provider Active NPI

Brandon Granil, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1154174936
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
827984 Issued in NV
Practice address
7061 Grand Montecito Pkwy
Las Vegas, NV 89149-0287
Phone
(702) 877-5199
Fax
(702) 750-3808
NPI assigned
Apr 10, 2024
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 827984 NV Primary

Addresses

Primary practice location

7061 Grand Montecito Pkwy
Las Vegas, NV 89149-0287

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240927000476 NV Practitioner - Nurse Practitioner 3476084716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Nevada, Las Vegas School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

7061 Grand Montecito Pkwy
Las Vegas, NV 89149-0287
Phone (702) 579-3253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C Current Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Sep 11, 2024 Accepting new patients
Southwest Medical Associates, Inc Past Accepting new patients

Locations

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

7061 Grand Montecito Pkwy
Las Vegas, NV 89149
Phone (702) 750-3800

Interoperability endpoints

  • Direct secure messaging: bgranil117674@westdirect.optum.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1154174936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7061 GRAND MONTECITO PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891490287",
            "telephone_number": "702-877-5199",
            "fax_number": "702-750-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANIL",
        "first_name": "BRANDON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "827984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.