Kenneth Granke, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301046290 Issued in MI

Practice address

2104 E 11 Mile Rd
Suite 600
Warren, MI 48091-6122

Phone

(734) 464-0887

Fax

(734) 402-0254

NPI assigned

Jun 1, 2006

Last updated

Jul 24, 2024By 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 2

Addresses

Other identifiers 1

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

Vascular Surgery

Education

Wayne State University School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CS Pacs 3 Midwest LLCGroup PAC ID 4183164734, 36 clinicians

Michigan Post-Acute Medical Services 1 PCGroup PAC ID 2163798877, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michigan Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Brighton, MI
  • NPI 1669901567
  Medicare reassignment Care Compare group NPD
• CS Pacs 3 Midwest LLC

  • Hospitalist Physician
  • Dayton, OH
  • NPI 1972368785

  Internal Medicine, MI

  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Michigan PC

  • Hospitalist Physician
  • Livonia, MI
  • NPI 1861442824

  Internal Medicine

  Medicare reassignment NPD
• Mi Pacs 2 PC

  • Hospitalist Physician
  • Northville, MI
  • NPI 1205418357
  Medicare reassignment NPD
• University Physician Group

  dba Wayne Health

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  Medicare reassignment NPD
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809
  NPD (past)

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

• McLaren Greater Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1134104672
  Care Compare affiliation

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1851338347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4967 CROOKS RD",
            "address_2": "STE 130",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480985801",
            "telephone_number": "248-952-1601",
            "fax_number": "248-952-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 E 11 MILE RD",
            "address_2": "SUITE 600",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480916122",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANKE",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301046290",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301046290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851338347",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edmund Michael Grady, MD
• Anne Patricia Graff, RN, NP
• Nekeya M Graham
• Roshundra Graham
• Cheryl Grames, PTA
• Angelena Alexis Grant
• Renee Graves
• Jessica Gray
• Derek Grayson, M.D.
• Great Lakes Family Dental Group-Warren, P.C.

• Internal Medicine Physician in Warren, MI
• Providers in Warren, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.