Individual provider Active NPI

Vanessa Grano, PA

  • Surgical Physician Assistant
  • Evanston, IL
National Provider Identifier
1174244800
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085010112 Issued in IL
Practice address
1000 Central St Ste 730
Evanston, IL 60201-1779
Phone
(773) 293-4170
Fax
(773) 989-3971
NPI assigned
Sep 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085010112 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1000 Central St Ste 730
Evanston, IL 60201-1779

Mailing address

1000 Central St Ste 730
Evanston, IL 60201-1779
Phone (773) 293-4170

Other practice location 1

5140 N. California Ave Suite 700-GMP
Chicago, IL 60625-3645
Phone (773) 293-4170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240304003418 IL Practitioner - Physician Assistant 9537504204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2100 Pfingsten Rd
Glenview, IL 60026-1301

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Feb 19, 2024 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

5140 N California Ave
Ste 700GMP
Chicago, IL 60625
Phone (773) 293-4170

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

1000 Central St
Evanston, IL 60201
Phone (847) 570-1000

1000 Central St
Ste 730
Evanston, IL 60201
Phone (847) 663-8410

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1174244800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CENTRAL ST STE 730",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011779",
            "telephone_number": "773-293-4170",
            "fax_number": "773-989-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CENTRAL ST STE 730",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011779",
            "telephone_number": "773-293-4170",
            "fax_number": "773-989-3971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5140 N. California Ave Suite 700-GMP",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606253645",
            "country_code": "US",
            "telephone_number": "773-293-4170",
            "fax_number": "773-989-3815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANO",
        "first_name": "VANESSA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2024-03-11",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085010112",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.