Mark S Grajcar, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

O127 Issued in ID

Practice address

2640 S Eagle Rd
Meridian, ID 83642-6704

Phone

(208) 884-0835

Fax

(208) 367-8135

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Oct 1, 2016 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Edge Medical LLC

  • Family Medicine Physician
  • Meridian, ID
  • NPI 1922814474
  NPD

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669416137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 S EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426704",
            "telephone_number": "208-884-0835",
            "fax_number": "208-367-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 S EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426704",
            "telephone_number": "208-884-0835",
            "fax_number": "208-367-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAJCAR",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace and Growth Counseling LLC
• Grace at Fairview Lakes LLC
• Joshua Randall Grade, LCSW
• Kylee J Graef, PA
• Chris Graham, LPC
• Teresa Graklanoff, PA-C
• Jason Gramajo, DPT
• Alison Grant, LPC
• Angela Marie Grant, NP-C
• Autumn Grant, FNP

• Family Medicine Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.