Carlos Jose Anciano Granadillo, M.D.
Individual provider Active NPI Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Greenville, NC
NPI 1154563906 · NPPES record last updated Jan 24, 2024
Key facts
- NPI
- 1154563906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X
- License
- 2013-01958 (NC)
- Practice address
- 115 Heart Dr
Greenville, NC 27834-8982 - Phone
- (252) 744-4400
- Fax
- (252) 744-3987
- NPI assigned
- Mar 25, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Thoracic Surgery
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- East Carolina University
Practice addresses (Care Compare)
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 209-3000
600 Moye Blvd
Greenville, NC 27834-4300
Phone (252) 744-4611
Hospital & facility affiliations
- Ecu Health Medical Center
- Carolina East Medical Center
- Vidant Duplin Hospital
- Carteret General Hospital
- Vidant Chowan Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.95 of 100
- Quality
- 82.44
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 142 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140428001619 | NC | Practitioner - Thoracic Surgery |
5294968202 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013-01958 | NC | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Carolina University | Current | Accepting new patients | |
| East Carolina University | Surgery | Current |
Accepting new patients |
| East Carolina University | Past | Accepting new patients |
Locations
115 Heart Dr
Greenville, NC 27834
Phone (252) 744-4400
600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2013-01958 | NC | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 2013-01958 | NC | Yes |
Addresses
Primary practice location
115 Heart Dr
Greenville, NC 27834-8982
Mailing address
PO Box 751069
Charlotte, NC 28275-1069
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154563906 | Medicaid | NC | |
| 184R0 | Other | NC | BCBS NC |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cancianogranadillo57797@direct.ecuhealth.com | Health Information Exchange (HIE) |
Other providers in Greenville, NC
- Makenzie Rae Ammons
- Leslie Spruill Amyette
- Hyunmo An
- Vivek Anand
- Anchorpoint Integrative Therapy, LLC
- Lenora Andersen
- Albert Delton Anderson Jr.
- Colby Ryan Anderson
- Jennifer Martin Anderson
- Mary Craft Anderson
All providers in Greenville, NC · Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.