Individual provider Active NPI

Jeffrey S Grant, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Farmington, NM
National Provider Identifier
1669500096
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
99216 Issued in NM
Practice address
608 E Comanche St
Farmington, NM 87401-6815
Phone
(505) 325-0072
Fax
(505) 327-1739
NPI assigned
Feb 28, 2007
Last updated
Sep 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 99216 NM Primary

Addresses

Primary practice location

608 E Comanche St
Farmington, NM 87401-6815

Mailing address

PO Box 677
Farmington, NM 87499-0677
Phone (505) 325-0072

Other identifiers 1

IdentifierTypeStateIssuer
99216OtherNMSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040720000315 NM Practitioner - Physical Medicine and RehabilitationPractitioner - Addiction Medicine 4587643705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Addiction Medicine
Education
State University of New York at Buffalo School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

608 E Comanche
Farmington, NM 87401-6815

608 E Comanche St
Farmington, NM 87401-6815
Phone (505) 325-0072

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
99216NMMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey S. Grant, M.D., P.C. Physical Medicine & Rehabilitation CurrentSince Apr 1, 2004 Accepting new patients

Locations

608 E Comanche St
Farmington, NM 87401
Phone (505) 325-0072

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1669500096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 677",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874990677",
            "telephone_number": "505-325-0072",
            "fax_number": "505-327-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 E COMANCHE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016815",
            "telephone_number": "505-325-0072",
            "fax_number": "505-327-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NM",
            "license": "99216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "99216",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.