Active NPI
Grant Elliot Schaneman, O.D.
- Corneal and Contact Management Optometrist
- Johnstown, CO
National Provider Identifier
1922058833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- 2410
- Practice address
- 257 Johnstown Center Dr
Suite 107
Johnstown, CO 80534-9073 - Phone
- (970) 587-0827
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 2410 | CO | Primary |
Addresses
Primary practice location
257 Johnstown Center Dr
Suite 107
Johnstown, CO 80534-9073
Mailing address
251 Hawthorne Ave
Johnstown, CO 80534-9184
Phone (970) 587-0827
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2204624 | Other | CO | EVERCARE |
| 74130293 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
16 N Parish Ave
Johnstown, CO 80534-9097
Phone (970) 587-0827
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 75 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1207 | NE | MD | Psychologist |
| 2410 | CO | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Precision Family Eyecare PC | Corneal and Contact Management | Current | Accepting new patients |
Locations
16 N Parish Ave
Johnstown, CO 80534
Phone (970) 587-0827
257 Johnstown Center Dr
Unit 107
Johnstown, CO 80534
Phone (816) 806-1664
Organizations & group practices 1
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.
-
- Corneal and Contact Management Optometrist
- Johnstown, CO
- NPI 1053356543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213142400000",
"number": "1922058833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 HAWTHORNE AVE",
"city": "JOHNSTOWN",
"state": "CO",
"postal_code": "805349184",
"telephone_number": "970-587-0827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "257 JOHNSTOWN CENTER DR",
"address_2": "SUITE 107",
"city": "JOHNSTOWN",
"state": "CO",
"postal_code": "805349073",
"telephone_number": "970-587-0827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHANEMAN",
"first_name": "GRANT",
"middle_name": "ELLIOT",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2008-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CO",
"license": "2410",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "2204624",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "74130293",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnstown, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.