Individual provider Active NPI

Chanda Annette Griessel, MD

  • Ophthalmology Physician
  • Winston Salem, NC
National Provider Identifier
1306856703
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
200301236 Issued in NC
Practice address
150 Kimel Park Dr Ste 200
Winston Salem, NC 27103-6992
Phone
(336) 760-2240
Fax
(336) 760-2239
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 200301236 NC Primary

Addresses

Primary practice location

150 Kimel Park Dr Ste 200
Winston Salem, NC 27103-6992

Mailing address

150 Kimel Park Dr
Suite 200
Winston Salem, NC 27103-6992
Phone (336) 760-2240

Other identifiers 1

IdentifierTypeStateIssuer
89135CAMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20031222000577 NC Practitioner - Ophthalmology 4385542802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Iowa, RJ & L Carver College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

150 Kimel Park Dr
Suite 200
Winston Salem, NC 27103-6992
Phone (336) 760-2240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.4 of 100Reported as individual
Quality
94.81
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200301236NCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Regional Medical Center Past Accepting new patients
Lindstrom Eye & Laser Center, P.a. Ophthalmology Past Accepting new patients
Forsyth Memorial Hospital, Inc. PastSince Dec 17, 2007 Accepting new patients
Temas Eye Center, PC Ophthalmology Past Accepting new patients

Organizations & group practices 5

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1306856703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 KIMEL PARK DR",
            "address_2": "SUITE 200",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036992",
            "telephone_number": "336-760-2240",
            "fax_number": "336-760-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 KIMEL PARK DR STE 200",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036992",
            "telephone_number": "336-760-2240",
            "fax_number": "336-760-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIESSEL",
        "first_name": "CHANDA",
        "middle_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "200301236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89135CA",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.