Individual provider Active NPI

Nicanor G Granados, M.D.

  • Family Medicine Physician
  • Reading, PA
National Provider Identifier
1639178353
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD014870E Issued in PA
Practice address
1555 Schuylkill Ave
Reading, PA 19601-1312
Phone
(610) 378-0107
Fax
(610) 378-7984
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD014870E PA Primary

Addresses

Primary practice location

1555 Schuylkill Ave
Reading, PA 19601-1312

Mailing address

9 Wyndham Hill Dr
Reading, PA 19606-9575
Phone (610) 779-4625

Other identifiers 2

IdentifierTypeStateIssuer
116351OtherPAPA BLUE SHIELD
01145201OtherPACAPITAL BLUE CROOS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD014870EPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Granados Medical Associates, P. C. Family Medicine PastSince Jan 1, 1990 Accepting new patients
Berks Genesis Family Medicine PC Family Medicine Past Accepting new patients
Wyomissing Behavior Analysts, LTD. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639178353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WYNDHAM HILL DR",
            "city": "READING",
            "state": "PA",
            "postal_code": "196069575",
            "telephone_number": "610-779-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SCHUYLKILL AVE",
            "city": "READING",
            "state": "PA",
            "postal_code": "196011312",
            "telephone_number": "610-378-0107",
            "fax_number": "610-378-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANADOS",
        "first_name": "NICANOR",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD014870E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "116351",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROOS",
            "identifier": "01145201",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.