Individual provider Active NPI

Alla Granatur

  • Family Nurse Practitioner
  • Marcy, NY
National Provider Identifier
1215464367
Registry record updated May 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F338762-1 Issued in NY
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191016003284 NY Order and Referring Only - Nurse Practitioner 1355672767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
338762NYMDEmergency Medicine Physician
F338762-1NYMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: agranatur@hiemail.healtheconnections.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F338762-1 NY Primary

Addresses

NPPES NPI Registry

Primary 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

Verify at the official NPI Registry.