Grant Niskanen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD18831 Issued in OR

Practice address

2865 Daggett Ave.
Klamath Falls, OR 97601

Phone

(541) 882-6311

Fax

(541) 882-6311

NPI assigned

Aug 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in OR

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

George Washington University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Medicare reassignment Care Compare group NPD
• Sky Lakes Medical Center Inc

  dba Sky Lakes Specialty Pharmacy

  • Community/Retail Pharmacy
  • Klamath Falls, OR
  • NPI 1003654625
  NPD

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

• Sky Lakes Medical Center Inc

  • Occupational Therapist
  • Klamath Falls, OR
  • NPI 1134270911

  Hospital

  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Care Compare affiliation

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1801898358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE.",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "97601",
            "telephone_number": "541-882-6311",
            "fax_number": "541-882-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE.",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "97601",
            "telephone_number": "541-882-6311",
            "fax_number": "541-882-6311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2821 Daggett Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976011106",
            "country_code": "US",
            "telephone_number": "541-274-8400",
            "fax_number": "541-274-8405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2821 Daggett Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976011106",
            "country_code": "US",
            "telephone_number": "541-274-6733",
            "fax_number": "541-274-2006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NISKANEN",
        "first_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2023-03-07",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD18831",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "9782",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006600",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "POO100692",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "0108854YPNH02",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30009720",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3059734PNH02",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5830418",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "8782",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicola J Cherry MD LLC (The Childrens Clinic of Klamath)
• Trava Nieves
• Nightingale Home Healthcare of Oregon, Inc.
• Lucia Nino
• Nisha Jackson PC
• Catherine Evelyn Noble, PA-C
• Yvette Pamela Noble
• Leyieta Noland
• William Noneo
• Norco, Inc.

• Family Medicine Physician in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.