NPIMap

Individual provider Active NPI

Steven J Granberg, MD

  • Interventional Pain Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1881673382
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
104051 Issued in MO
Practice address
13131 Tesson Ferry Rd
Suite #105
Saint Louis, MO 63128-3887
Phone
(314) 756-8035
Fax
(314) 756-8050
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 104051 MO
Interventional Pain Medicine Physician 208VP0014X 104051 MO Primary

Addresses

Primary practice location

13131 Tesson Ferry Rd
Suite #105
Saint Louis, MO 63128-3887

Mailing address

13131 Tesson Ferry Rd
Suite #105
Saint Louis, MO 63128-3887
Phone (314) 756-8035

Other identifiers 1

IdentifierTypeStateIssuer
208256917MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061031000300 MO Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 5092712240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
Saint Louis University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Pain Management, LLCGroup PAC ID 0244303774, 4 clinicians

Practice addresses (Care Compare)

13131 Tesson Ferry Rd
Suite 105
Saint Louis, MO 63128-3887
Phone (314) 756-8035

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
104051MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Pain Management, LLC Interventional Pain Medicine CurrentSince Jun 30, 2008 Accepting new patients
South County Anesthesia Associates, LTD. Anesthesiology Past Accepting new patients

Locations

13131 Tesson Ferry Rd
Ste 105
Saint Louis, MO 63128
Phone (314) 756-8035

112 Piper Hill Dr
Ste 1
Saint Peters, MO 63376
Phone 6364413444 ext. 352

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHHECA
  • Direct secure messaging: steven.granberg@mpmpain.eclinicaldirectplus.com

Organizations & group practices 2

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 5

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1881673382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13131 TESSON FERRY RD",
            "address_2": "SUITE #105",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283887",
            "telephone_number": "314-756-8035",
            "fax_number": "314-756-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13131 TESSON FERRY RD",
            "address_2": "SUITE #105",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283887",
            "telephone_number": "314-756-8035",
            "fax_number": "314-756-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANBERG",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "104051",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MO",
            "license": "104051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208256917",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.