Grant Surgicenter LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GRANT SURGICENTER LLC

Practice address

2000 Grant Ave
Philadelphia, PA 19115-7287

Phone

(215) 992-6000

Fax

(215) 992-6001

NPI assigned

Nov 30, 2010

Organization subpart

No

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

Authorized official

Name

Jonathan Bailey, MD

Title

Officer/Ao

Phone

(203) 609-1168

Specialties & licenses 1

Addresses

Electronic endpoints 1

Listed as

Grant Surgicenter LLCCCN 39C0001287

Medicare certification status

Terminated Voluntary: merger or closure, Aug 1, 2025From the Provider of Services file

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• GSC Anesthesia

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
  • NPI 1134718885

  Member Of

  NPD member

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Lieb, MD

  • Specialist
  • Phila, PA
  • NPI 1770641581
  NPD (past)
• Tara Lynn Pettit, CRNA, MSN

  • Certified Registered Nurse Anesthetist
  • Camden, NJ
  • NPI 1205155223
  NPD (past)

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1194027920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GRANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191157287",
            "telephone_number": "215-992-6000",
            "fax_number": "215-992-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GRANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191157287",
            "telephone_number": "215-992-6000",
            "fax_number": "215-992-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT SURGICENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OFFICER/AO",
        "authorized_official_telephone_number": "203-609-1168",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Veronica Grankina, MA
• Larisa Granovsky, DC
• Eric Granquist, DMD
• Caroline Blake Granruth, MD
• Grant Academy Dental LLC
• Corrine N Grant
• Eleonore Grant, MD
• Karen Grant, LSW
• Kinzya Bernice Grant, MD
• Lance Jeremiah Grant

• Ambulatory Surgical Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.