Michael A Granovsky, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

D0046947 Issued in MD

Practice address

11711 Livingston Rd
Ft Washington, MD 20744-5151

Phone

(301) 203-2250

NPI assigned

Mar 31, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Greater Washington Emergency Physicians Chartered

  • Specialist
  • Fort Washington, MD
  • NPI 1346389988
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1881655652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 500",
            "city": "MARSHALL",
            "state": "VA",
            "postal_code": "201160500",
            "telephone_number": "301-686-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11711 LIVINGSTON RD",
            "city": "FT WASHINGTON",
            "state": "MD",
            "postal_code": "207445151",
            "telephone_number": "301-203-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANOVSKY",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0046947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "550300100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017158500",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BLUE SHIELD",
            "identifier": "76881001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC BLUE SHIELD",
            "identifier": "H9140003",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Gladney
• Elena Golden-Cook
• Charmicielle Venters Goodine, BCBA
• Matthew Joseph Gordon, NP-BC
• Grace Compassionate Health Care
• Latoya Devonn Graves
• Ketia Gray
• Greater Washington Emergency Physicians Chartered
• Carmella Greene
• Alexandria O Grey, LCPC

• Emergency Medicine Physician in Ft Washington, MD
• Providers in Ft Washington, MD by specialty
• Emergency Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.