Individual provider Active NPI

Megan Jurecko Gracy, DMD

  • Endodontics
  • Gainesville, FL
National Provider Identifier
1336251578
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN15992 Issued in FL
Practice address
1204 NW 69TH Terrace
Suite C
Gainesville, FL 32605
Phone
(352) 332-3788
Fax
(352) 332-3791
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN15992 FL Primary

Addresses

Primary practice location

1204 NW 69TH Terrace
Suite C
Gainesville, FL 32605

Mailing address

1204 NW 69TH Terrace
Suite C
Gainesville, FL 32605
Phone (352) 332-3788

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150514001668 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8628398633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Megan Jurecko Gracy, DMD Endodontics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336251578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 NW 69TH TERRACE",
            "address_2": "SUITE C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-332-3788",
            "fax_number": "352-332-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 NW 69TH TERRACE",
            "address_2": "SUITE C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-332-3788",
            "fax_number": "352-332-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACY",
        "first_name": "MEGAN",
        "middle_name": "JURECKO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN15992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.