Viktorija Grajevskaja

Primary specialty

DentistTaxonomy code 122300000X

License

DS043320 Issued in PA

Practice address

45 N Pine St
Port Allegany, PA 16743-1238

Phone

(814) 642-7232

NPI assigned

Jul 20, 2021

Last updated

Jul 30, 2021By the provider in NPPES

Sex

Female

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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vgrajevskaja513736@upmc.direct-ci.com

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.

• Charles Cole Memorial Hospital

  dba UPMC Cole

  • Critical Access Hospital
  • Coudersport, PA
  • NPI 1326161662
  Medicare reassignment
• Charles Cole Memorial Hospital

  • Obstetrics & Gynecology Physician
  • Coudersport, PA
  • NPI 1548637051
  NPD

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1730752619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N PINE ST",
            "city": "PORT ALLEGANY",
            "state": "PA",
            "postal_code": "167431238",
            "telephone_number": "814-642-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAJEVSKAJA",
        "first_name": "VIKTORIJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS043320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edwin M Schott OD PC (Schott Associates Eye Care)
• Jane Evingham, RN
• Michael Jerome Farber, RPH
• Rebecca Gardner, PA-C
• Donald Ryan Geci, PA-C
• Heather Deimler Kio, CRNP
• Richard A Kunkel, DDS
• Daniel F Kysor
• Ashley Nicole Major, LMSW
• Amy Jo Mickle, LPC

• Dentist in Port Allegany, PA
• Providers in Port Allegany, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.