NPIMap

Individual provider Active NPI

Darla Kae Granger, MD

  • Surgery Physician
  • Detroit, MI
National Provider Identifier
1700999083
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301080825 Issued in MI
Practice address
22101 Moross Rd
PB 2 Ste 480
Detroit, MI 48236
Phone
(313) 343-3048
Fax
(313) 343-7349
NPI assigned
Aug 17, 2006
Last updated
Mar 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301080825 MI Primary
Surgery Physician 208600000X 33528 MN

Addresses

Primary practice location

22101 Moross Rd
PB 2 Ste 480
Detroit, MI 48236

Mailing address

22101 Moross Rd
PB 2 Ste 480
Detroit, MI 48236
Phone (313) 343-3048

Other identifiers 1

IdentifierTypeStateIssuer
4694661MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040917000348 MI Practitioner - General Surgery 4284602343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22201 Moross Rd
Suite 252
Detroit, MI 48236-2175
Phone (313) 343-4411

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Oct 8, 2004 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Oct 8, 2004 Accepting new patients
Henry Ford Health St. John Hospital Surgery Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
University Surgical Associates, PSC Surgery Past Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22101 Moross Rd
#2
Detroit, MI 48236
Phone (313) 343-4449

22101 Moross Rd
Ste 480
Detroit, MI 48236
Phone (313) 343-3048

22201 Moross Rd
Ste 252
Grosse Pointe, MI 48236
Phone (313) 343-4411

Interoperability endpoints

  • Direct secure messaging: dgranger1130510@direct.hfhs.org

Organizations & group practices 6

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 4

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1700999083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "address_2": "PB 2 STE 480",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48236",
            "telephone_number": "313-343-3048",
            "fax_number": "313-343-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "address_2": "PB 2 STE 480",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48236",
            "telephone_number": "313-343-3048",
            "fax_number": "313-343-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "DARLA",
        "middle_name": "KAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301080825",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "33528",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4694661",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.