Mark Granados

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

025159 Issued in NY

Practice address

100 Port Washington Blvd
Roslyn, NY 11576-1347

Phone

(516) 562-6000

NPI assigned

Jul 14, 2020

Last updated

Jul 14, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Physician Services PCGroup PAC ID 6204140544, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.granados.1@8960.direct.athenahealth.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.

• Modern Physician Services PC

  dba ModernMD Urgent Care

  • Urgent Care Clinic/Center
  • Brooklyn, NY
  • NPI 1932590601
  Medicare reassignment Care Compare group
• Mercy Medical Center

  • Internal Medicine Physician
  • Rockville Centre, NY
  • NPI 1619245610
  Medicare reassignment
• Progressive Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Uniondale, NY
  • NPI 1588098172
  Medicare reassignment
• St. Francis Hospital

  dba St. Francis Hospitalists

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1760704811
  Medicare reassignment
• Mercy Medical Center

  • Internal Medicine Physician
  • Rockville Centre, NY
  • NPI 1104097294
  NPD
• Mercy Medical Center

  dba Mercy Medical Center - Radiology

  • Diagnostic Radiology Physician
  • Rockville Centre, NY
  • NPI 1124062369
  NPD
• St Francis Hospital United States Catholic Conference

  dba St Francis Ekg

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1750439030
  NPD
• St. Francis Hospital

  • Cardiovascular Disease Physician
  • West Islip, NY
  • NPI 1528386810
  NPD

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1871101006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 ELM DR",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117062135",
            "telephone_number": "516-808-5932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761347",
            "telephone_number": "516-562-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANADOS",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helene Danielle Gourdet, PHYSICIAN ASSISTANT
• Danielle Gournelos
• Dev Raj Goyal, MD
• John Paul Gozaloff, PT
• John Graffeo, P.A.
• Adrienne G Grande, PA
• Svetlana Granik, M.D.
• Karen Grauer, P.A.
• Stewart J Grauer, DDS MS
• Adam Graziani, MD

• Physician Assistant in Roslyn, NY
• Providers in Roslyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.