Mica Dianna Grantham

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MD210002279 Issued in DC

Practice address

2041 Georgia Avenue, NW
1M05
Washington, DC 20060-0001

Phone

(202) 865-1354

NPI assigned

Jun 7, 2011

Sex

Female

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 DC

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

Pathology

Education

Howard University College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Howard UniversityGroup PAC ID 0941109565, 182 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Howard University Hospital Corp Hospital, Washington, DC, CCN 090003

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 and National Provider Directory roles.

• Howard University

  • Multi-Specialty Clinic/Center
  • Washington, DC
  • NPI 1033163597
  Medicare reassignment Care Compare group NPD

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

• Howard University Hospital Corp

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1487740957
  Care Compare affiliation

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1336433390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVE NW STE 1M05",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200600001",
            "telephone_number": "202-865-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVENUE, NW",
            "address_2": "1M05",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200600001",
            "telephone_number": "202-865-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "MICA",
        "middle_name": "DIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "DE",
            "license": "C1-0011207",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD453773",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "DC",
            "license": "MD210002279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra Grant, HHA
• Sylvia Grant
• Trenton Grant, LGSW
• Erica Granteed, AG-ACNP-BC
• Grantgrayton
• Katherine Laughon Grantz, M.D.
• Rachel Grasfield, DO
• Dana J Grasso, MA, PSY.D.
• Ethan William Graure
• Kylie Jane Gravatt

• Anatomic Pathology & Clinical Pathology Physician in Washington, DC
• Providers in Washington, DC by specialty
• Anatomic Pathology & Clinical Pathology Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.