Individual provider Active NPI

Greg Thomas Graglia, DPM

  • Podiatrist
  • Watertown, WI
National Provider Identifier
1841244555
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
871025 Issued in WI
Practice address
101 Oakridge CT
Suite a
Watertown, WI 53094-4150
Phone
(920) 261-9610
Fax
(920) 261-9671
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 871025 WI Primary

Addresses

Primary practice location

101 Oakridge CT
Suite a
Watertown, WI 53094-4150

Mailing address

101 Oakridge CT
Suite a
Watertown, WI 53094-4150
Phone (920) 261-9610

Other identifiers 1

IdentifierTypeStateIssuer
43236600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20040609001390 WI Practitioner - Podiatry 3971586025 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rock River Foot and Ankle Clinic, SCGroup PAC ID 3577554526, 3 clinicians
Watertown Physician Practices LLCGroup PAC ID 8022329408, 64 clinicians

Practice addresses (Care Compare)

101 Oakridge CT
Suite a
Watertown, WI 53094-4150
Phone (920) 261-9610

344 S Western Ave
Juneau, WI 53039-1163
Phone (920) 386-0290

Hospital & facility affiliations

  • Watertown Memorial Hospital Hospital, Watertown, WI, CCN 520116
  • Fort Memorial Hospital Hospital, Fort Atkinson, WI, CCN 520071

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue89
Removal of skin lesions1-10
Removal of nail tissue1187
Removal or shaving of skin growth99

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
871025WIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Healthcare Inc CurrentSince Jan 15, 2015 Accepting new patients
Watertown Physician Practices LLC CurrentSince Jan 15, 2016 Accepting new patients
Fort Healthcare Inc CurrentSince Jan 15, 2015 Accepting new patients
Rock River Foot & Ankle Clinic, SC Podiatrist CurrentSince Jul 1, 2004 Accepting new patients
Watertown Physician Practices LLC CurrentSince Jan 15, 2016 Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

303 Hake St
Fort Atkinson, WI 53538
Phone (920) 563-2136

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

400 Doctors Ct
Johnson Creek, WI 53038
Phone (920) 699-4000

400 Doctors Ct
#1
Johnson Creek, WI 53038
Phone (920) 699-4000

344 S Western Ave
Juneau, WI 53039

344 S Western Ave
Juneau, WI 53039
Phone (920) 386-0290

101 Oakridge Ct
Ste A
Watertown, WI 53094
Phone (920) 261-9610

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

101 Oakridge Ct
Watertown, WI 53094
Phone (920) 261-5400

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/
  • Direct secure messaging: ggraglia@usfas.emadirect.md

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257984000000",
    "number": "1841244555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 OAKRIDGE CT",
            "address_2": "SUITE A",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530944150",
            "telephone_number": "920-261-9610",
            "fax_number": "920-261-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OAKRIDGE CT",
            "address_2": "SUITE A",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530944150",
            "telephone_number": "920-261-9610",
            "fax_number": "920-261-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAGLIA",
        "first_name": "GREG",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2009-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "871025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43236600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

Verify at the official NPI Registry.