Glenn A Gradis, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101006988 Issued in MI

Practice address

3950 S Rochester Rd
Suite 1200
Rochester Hills, MI 48307-5160

Phone

(248) 844-6000

Fax

(248) 844-6159

NPI assigned

Jan 25, 2006

Last updated

Dec 6, 2013By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ggradis1130472@direct.hfhs.org

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.

• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Michigan Healthcare Professionals PC

  dba Urology Specialist of Michigan

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1679543292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 S ROCHESTER RD",
            "address_2": "SUITE 1200",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075160",
            "telephone_number": "248-844-6000",
            "fax_number": "248-844-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 S ROCHESTER RD",
            "address_2": "SUITE 1200",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075160",
            "telephone_number": "248-844-6000",
            "fax_number": "248-844-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADIS",
        "first_name": "GLENN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101006988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP",
            "identifier": "700H273300",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679543292",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Rene Goris, LPC
• Rani Goriyo
• Debra Kay Gorney-Jankowski, MSN, RNCS
• Sachi Gowda, M.D.
• Patricia Lynn Goymerac, M.D.
• Robert Cormack Grafton, M.D.
• Krystal Graziosi, FNP-BC
• Great Lakes Sleep and Orofacial Pain Clinic
• Great Minds of Michigan PLLC
• Ashley Greene, MA, LPC

• Family Medicine Physician in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.
• 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.

Verify at the official NPI Registry.