Active NPI
Dennis J Grandic I, PT
- Orthopedic Physical Therapist
- Alexandria, VA
National Provider Identifier
1508191560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 2305210108
- Practice address
- 6355 Walker LN
Suite 512
Alexandria, VA 22310-3245 - Phone
- (855) 546-0726
- Fax
- (703) 822-9955
- NPI assigned
- Oct 8, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT24546 | FL | |
| Orthopedic Physical Therapist | 2251X0800X | 2305210108 | VA | Primary |
Addresses
Primary practice location
6355 Walker LN
Suite 512
Alexandria, VA 22310-3245
Mailing address
2402 NW 6TH St
Boynton Beach, FL 33426-8754
Phone (917) 566-0158
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3712 Linda LN
Annandale, VA 22003-1510
Phone (866) 525-3175
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT24546 | FL | MD | Orthopedic Physical Therapist |
| 2305210108 | VA | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia Luna Care Physical Therapy LLC | Orthopedic | Current | Accepting new patients |
| Orthopedic Center of Palm Beach County, LLC | Past | Accepting new patients | |
| Orthopedic Center of Palm Beach County, LLC | Past | Accepting new patients | |
| Orthopaedic Associates of Central Maryland, PA | Past | Accepting new patients |
Locations
8280 Willow Oaks Corporate Dr
Ste 600
Fairfax, VA 22031
Phone (202) 794-7159
Organizations & group practices 5
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.
-
- Physical Therapist
- Fairfax, VA
- NPI 1235720848
DC, Orthopedic
-
- Orthopaedic Surgery Physician
- Winchester, VA
- NPI 1861221863
-
- Orthopaedic Surgery Physician
- Columbia, MD
- NPI 1023269396
-
dba Sports and Orthopedic Center
- Specialist
- Atlantis, FL
- NPI 1114079738
-
- Orthopaedic Surgery Physician
- Atlantis, FL
- NPI 1164963252
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702944000000",
"number": "1508191560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2402 NW 6TH ST",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334268754",
"telephone_number": "917-566-0158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6355 WALKER LN",
"address_2": "SUITE 512",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223103245",
"telephone_number": "855-546-0726",
"fax_number": "703-822-9955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANDIC",
"first_name": "DENNIS",
"middle_name": "J",
"name_prefix": "Mr.",
"name_suffix": "I",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-08",
"last_updated": "2023-12-19",
"certification_date": "2023-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "FL",
"license": "PT24546",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "VA",
"license": "2305210108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.