Individual provider Active NPI

Vanessa Nicole Grauds, PA

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1902668528
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118481 Issued in FL
Practice address
5 Tampa General Cir
Tampa, FL 33606-3601
Phone
(813) 844-7137
NPI assigned
Jan 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9118481 FL Primary

Addresses

Primary practice location

5 Tampa General Cir
Tampa, FL 33606-3601

Mailing address

904 Spicebush Dr
Leland, NC 28479-5679
Phone (774) 313-6981

Other identifiers 2

IdentifierTypeStateIssuer
121666100MedicaidFL
0QNPROtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vgrauds293474@direct.tgh.org

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240321001472 FL Practitioner - Physician Assistant 8426495854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Medical Service Association IncGroup PAC ID 6800790221, 818 clinicians

Practice addresses (Care Compare)

4202 E Fowler Ave
Tampa, FL 33620-6750

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9118481FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc CurrentSince Mar 11, 2024 Accepting new patients
University Medical Service Association Inc CurrentSince Mar 11, 2024 Accepting new patients
University Medical Service Association Inc Physician Assistant Past Accepting new patients

Locations

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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 1

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": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1902668528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 SPICEBUSH DR",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284795679",
            "telephone_number": "774-313-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063601",
            "telephone_number": "813-844-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAUDS",
        "first_name": "VANESSA",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121666100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0QNPR",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vgrauds293474@direct.tgh.org",
            "affiliation": "N",
            "address_1": "5 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.