Individual provider Active NPI

Brian Graytok, OD

  • Student in an Organized Health Care Education/Training Program
  • Greensburg, PA
National Provider Identifier
1487384939
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
235 Humphrey Rd Ste 1
Greensburg, PA 15601-4579
Phone
(724) 834-8033
NPI assigned
Jun 15, 2022
Last updated
Jan 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Optometrist 152W00000X OEG003948 PA

Addresses

Primary practice location

235 Humphrey Rd Ste 1
Greensburg, PA 15601-4579

Mailing address

235 Humphrey Rd Ste 1
Greensburg, PA 15601-4579
Phone (724) 834-8033

Other practice location 1

412 W Main St
Ligonier, PA 15658-1014
Phone (724) 401-1620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230106001438 PA Practitioner - Optometry 6608246723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graytok Family Vision CareGroup PAC ID 2567903578, 2 clinicians

Practice addresses (Care Compare)

235 Humphrey Rd
Suite 1
Greenburg, PA 15601-4579
Phone (724) 834-8033

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003948PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
A. L. McConnell Jr. OD & Associates Optometrist Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1487384939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 HUMPHREY RD STE 1",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156014579",
            "telephone_number": "724-834-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 HUMPHREY RD STE 1",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156014579",
            "telephone_number": "724-834-8033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 W Main St",
            "address_purpose": "LOCATION",
            "city": "Ligonier",
            "state": "PA",
            "postal_code": "156581014",
            "country_code": "US",
            "telephone_number": "724-401-1620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAYTOK",
        "first_name": "BRIAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-15",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.