Lance Francis Grenevicki, MD, DDS, FACS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

ME77063 Issued in FL

Practice address

1093 S Wickham Rd
The Institute of Facial Surgery
West Melbourne, FL 32904-1652

Phone

(321) 674-3900

Fax

(321) 722-3303

NPI assigned

Feb 18, 2006

Last updated

Jan 21, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial Surgery

Education

University of Missouri, Kansas City, School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
• Orlando Health Melbourne Hospital Hospital, Melbourne, FL, CCN 100291

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Institute of Facial Surgery Inc

  • Specialist
  • West Melbourne, FL
  • NPI 1386855096
  Medicare reassignment NPD Authorized official

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

• Holmes Regional Medical Center, Inc.

  dba First Flight

  • Air Ambulance
  • Melbourne, FL
  • NPI 1235312281

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1295702728
  Care Compare affiliation
• Ohmh, LLC

  dba Orlando Health Melbourne Hospital

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1033937883
  Care Compare affiliation

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

{
    "created_epoch": "1140220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1255306866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 S WICKHAM RD",
            "address_2": "THE INSTITUTE OF FACIAL SURGERY",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329041652",
            "telephone_number": "321-674-3900",
            "fax_number": "321-722-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1093 S WICKHAM RD",
            "address_2": "THE INSTITUTE OF FACIAL SURGERY",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329041652",
            "telephone_number": "321-674-3900",
            "fax_number": "321-722-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENEVICKI",
        "first_name": "LANCE",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "MD, DDS, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-18",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "ME77063",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME77063",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN15027",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Apphia Glenn, RCSWI
• Michelle Gonzalez
• Bradley P Grant, M.D.
• James E Greathouse Jr., D.C.
• Deana Green
• Sydney Guard
• Rajani Guditi, PA-C
• H2 Rehabilitation Services of Florida LLC (Beachside Physical Therapy)
• Monique A Hall
• Liina Hanson, MD

• Oral & Maxillofacial Surgery (D.M.D.) in West Melbourne, FL
• Providers in West Melbourne, FL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.

Verify at the official NPI Registry.