Active NPI
Paul B. Graniero, M.D.
- Family Medicine Physician
- Port Charlotte, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME55719
- Practice address
- 21297 Olean Blvd Ste a
Port Charlotte, FL 33952-6704 - Phone
- (855) 979-5700
- Fax
- (855) 979-5701
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME55719 | FL | Primary |
Addresses
Primary practice location
21297 Olean Blvd Ste a
Port Charlotte, FL 33952-6704
Mailing address
2675 Winkler Ave FL 2Floor
Fort Myers, FL 33901-9342
Phone (877) 856-3774
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080111648 | Other | RAILROAD MEDICARE | |
| 09903 | Other | BLUECROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2315 Aaron St
Port Charlotte, FL 33952-5305
Phone (941) 613-2222
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME55719 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millennium Physician Group LLC | Family Medicine | Current | Accepting new patients |
| Millennium Physician Group LLC | Family Medicine | Current | Accepting new patients |
| Murdock Family Medicine LLC | Family Medicine | Past | Accepting new patients |
Locations
2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700
3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108
3434 Hancock Bridge Pkwy
North Ft Myers, FL 33903
2351 Aaron St
Port Charlotte, FL 33952
Phone (855) 674-7500
2315 Aaron St
Port Charlotte, FL 33952
Phone (941) 613-2222
21297 Olean Blvd
#A
Pt Charlotte, FL 33952
Phone (855) 979-5700
2450 Tamiami Trl
Ste A
Pt Charlotte, FL 33952
Phone (941) 235-3447
19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Fort Myers, FL
- NPI 1811122880
-
- Family Medicine Physician
- Brooksville, FL
- NPI 1073131702
-
- Family Medicine Physician
- Port Charlotte, FL
- NPI 1538190186
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port Charlotte, FL
- NPI 1417901406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574812800000",
"number": "1205868981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2675 WINKLER AVE FL 2FLOOR",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339019342",
"telephone_number": "877-856-3774",
"fax_number": "239-599-2625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21297 OLEAN BLVD STE A",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339526704",
"telephone_number": "855-979-5700",
"fax_number": "855-979-5701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANIERO",
"first_name": "PAUL",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2019-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME55719",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080111648",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUE SHIELD",
"identifier": "09903",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.