Individual provider Active NPI

Cristian Gragnaniello

  • Neurological Surgery Physician
  • San Antonio, TX
National Provider Identifier
1255875803
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
47795 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-8555
Fax
(210) 358-8576
NPI assigned
Dec 15, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MTL003987 DC
Neurological Surgery Physician 207T00000X 47795 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-8555

Other practice location 1

7400 Merton Minter St
San Antonio, TX 78229-4404
Phone (210) 617-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200306001595 IL Practitioner - Neurosurgery 9638422983 Reassigns benefits to 1 organization
I20210929002122 TX Practitioner - Neurosurgery 9638422983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MTL003987DCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Sep 1, 2021 Accepting new patients
University of Texas Health Science Center at San Antonio Neurological Surgery CurrentSince Sep 1, 2021 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jan 14, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Neurological Surgery CurrentSince Jan 14, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Bexar County Hospital District Past Accepting new patients

Locations

912 S Wood St
Chicago, IL 60612
Phone (312) 996-2200

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

7400 Merton Minter St
San Antonio, TX 78229
Phone (210) 616-8385

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1255875803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-8555",
            "fax_number": "210-358-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-8555",
            "fax_number": "210-358-8576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7400 Merton Minter St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294404",
            "country_code": "US",
            "telephone_number": "210-617-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAGNANIELLO",
        "first_name": "CRISTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-15",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "DC",
            "license": "MTL003987",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "47795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.