Individual provider Active NPI

Elise Michelle McCormack-Granja, M.D.

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1417190752
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME116563 Issued in FL
Practice address
8940 N Kendall Dr Ste 901E
Miami, FL 33176-2176
Phone
(786) 596-5007
Fax
(786) 533-9562
NPI assigned
Apr 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD038046 DC
Internal Medicine Physician 207R00000X MD13250 RI
Internal Medicine Physician 207R00000X ME116563 FL Primary

Addresses

Primary practice location

8940 N Kendall Dr Ste 901E
Miami, FL 33176-2176

Mailing address

PO Box 198054
Atlanta, GA 30384-8054
Phone (786) 596-5007

Other names 1

  • Dr. Elise Michelle McCormack Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elisem@cerner.directbaptisthealth.com

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131114000574 FL Practitioner - Internal Medicine 5294869293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group Physicians LLCGroup PAC ID 3870696933, 661 clinicians

Practice addresses (Care Compare)

11535 N Kendall Dr
Miami, FL 33176-1002
Phone (786) 595-8000

6200 Sunset Dr
Suite 604
South Miami, FL 33143-4831
Phone (786) 662-8928

6200 SW 72 St
Suite 602
South Miami, FL 33143-4831
Phone (786) 662-0600

6200 SW 72ND St Mci Benign Urology
Suite 601
South Miami, FL 33143-4831
Phone (786) 596-2000

Hospital & facility affiliations

  • Baptist Hospital of Miami Hospital, Miami, FL, CCN 100008
  • South Miami Hospital Hospital, Miami, FL, CCN 100154
  • Homestead Hospital Hospital, Homestead, FL, CCN 100125

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD038046DCMDInternal Medicine Physician
MD13250RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Physicians LLC CurrentSince Oct 8, 2013 Accepting new patients
Mark P. Caruso M.D.P.a. Past Accepting new patients

Locations

7101 SW 99th Ave
Ste 108
Miami, FL 33173
Phone (305) 596-5966

8940 N Kendall Dr
Ste 901E
Miami, FL 33176
Phone (786) 596-5007

8940 N Kendall Dr
Ste 900E
Miami, FL 33176
Phone (786) 596-5007

6200 Sunset Dr
Ste 604
South Miami, FL 33143
Phone (305) 853-9240

Interoperability endpoints

  • Direct secure messaging: elisem@cerner.directbaptisthealth.com

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 3

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": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1417190752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198054",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848054",
            "telephone_number": "786-596-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8940 N KENDALL DR STE 901E",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762176",
            "telephone_number": "786-596-5007",
            "fax_number": "786-533-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK-GRANJA",
        "first_name": "ELISE",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD038046",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD13250",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME116563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elisem@cerner.directbaptisthealth.com",
            "affiliation": "N",
            "address_1": "8940 N Kendall Dr Ste 901E",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331762176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELISE",
            "last_name": "MCCORMACK",
            "middle_name": "MICHELLE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.