Active NPI
Alla Granatur
- Family Nurse Practitioner
- Marcy, NY
National Provider Identifier
1215464367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F338762-1
- Practice address
- 9005 Old River Rd
Marcy, NY 13403-3000 - Phone
- (315) 765-3360
- NPI assigned
- May 20, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191016003284 | NY | Order and Referring Only - Nurse Practitioner | 1355672767 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 338762 | NY | MD | Emergency Medicine Physician |
| F338762-1 | NY | MD | Family Nurse Practitioner |
Interoperability endpoints
- agranatur@hiemail.healtheconnections.org
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F338762-1 | NY | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
9005 Old River Rd
Marcy, NY 13403-3000
Mailing address
PO Box 300
Marcy, NY 13403-0300
Phone (315) 765-3360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 20, 2017.
{
"created_epoch": "1495238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495238400000",
"number": "1215464367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 300",
"city": "MARCY",
"state": "NY",
"postal_code": "134030300",
"telephone_number": "315-765-3360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9005 OLD RIVER RD",
"city": "MARCY",
"state": "NY",
"postal_code": "134033000",
"telephone_number": "315-765-3360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANATUR",
"first_name": "ALLA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-20",
"last_updated": "2017-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F338762-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marcy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.