NPIMap

Individual provider Active NPI

Kimberly A Grannis, M.D.

  • Orthopaedic Trauma Physician
  • Sacramento, CA
National Provider Identifier
1326466848
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
A138068 Issued in CA
Practice address
4860 Y St
Sacramento, CA 95817
Phone
(916) 734-2182
NPI assigned
Apr 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X A138068 CA Primary

Addresses

Primary practice location

4860 Y St
Sacramento, CA 95817

Mailing address

4860 Y St Ste 3800
Sacramento, CA 95817-2307

Other practice location 1

155 N Fresno St
Suite 251
Fresno, CA 93701-2302
Phone (559) 459-4004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191111000375 CA Practitioner - Orthopedic Surgery 0749612901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Wright State University Boonshoft School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Agnes Medical FoundationGroup PAC ID 7618946369, 161 clinicians

Practice addresses (Care Compare)

1510 E Herndon Ave
Suite 110
Fresno, CA 93720-3333
Phone (559) 450-6742

Hospital & facility affiliations

  • Compassionate Care Home Health Agency, LLC Home health agency, Fresno, CA, CCN 058233
  • Focus Health Home health agency, Fresno, CA, CCN 557764
  • Ardent Home Health & Palliative Care Home health agency, Fresno, CA, CCN 559016
  • Prohealth Home Care, Inc Home health agency, Stockton, CA, CCN 059612
  • Saint Agnes Home Health and Hospice Home health agency, Fresno, CA, CCN 057135
  • Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093
  • San Joaquin Valley Rehabilitation Hosp Inpatient rehabilitation facility, Fresno, CA, CCN 053032

Merit-based Incentive Payment System (MIPS)

Final score
85.57 of 100Reported as group
Quality
63.43
Promoting interoperability
98
Improvement activities
40
Cost
77.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A138068CAMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LQMG Medical Group Inc. Current Accepting new patients
Saint Agnes Medical Foundation CurrentSince Sep 1, 2020 Accepting new patients

Locations

1510 E Herndon Ave
Ste 110
Fresno, CA 93720
Phone (559) 450-6742

1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777

1510 E Herndon Ave
Ste 230
Fresno, CA 93720
Phone (559) 450-2663

Interoperability endpoints

  • Direct secure messaging: kgrannis2714666@direct.trinity-health.org

Organizations & group practices 2

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 8

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1326466848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 Y ST STE 3800",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 Y ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95817",
            "telephone_number": "916-734-2182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 N Fresno St",
            "address_2": "Suite 251",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937012302",
            "country_code": "US",
            "telephone_number": "559-459-4004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANNIS",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "CA",
            "license": "A138068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.