Iris Ann Granek, M.D.

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

147963 Issued in NY

Practice address

631 Jayne Blvd
Port Jefferson Station, NY 11776-2947

Phone

(631) 928-9396

Fax

(631) 444-7525

NPI assigned

May 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: iris.granek@direct.stonybrookmedicine.edu

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.

• Stony Brook Preventive Medicine Services, Univ Fclty Practice Corp

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Stony Brook, NY
  • NPI 1164478749
  NPD (past) Authorized official

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

{
    "created_epoch": "1178928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1619182649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 JAYNE BLVD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762947",
            "telephone_number": "631-928-9396",
            "fax_number": "631-444-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 JAYNE BLVD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762947",
            "telephone_number": "631-928-9396",
            "fax_number": "631-444-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANEK",
        "first_name": "IRIS",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-12",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NY",
            "license": "147963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nithya Gopal, M.D.
• Dinamarie Gordon, R.N.
• Kinjal Amit Gosalia, STUDENT
• Daniel Gottfried, APRN, FNP
• Thomas Grandville, D.D.S.
• Arron Jordan Gravina
• Katherine McCauley Graziano, OTR/L, PT, DPT, CLT
• Keriann Marie Greehy, LPN
• Karen Greenwood, M.S.W.
• Gregory J Diehl MD PC

• Public Health & General Preventive Medicine Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Public Health & General Preventive Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.