Terri Granillo

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

54003 Issued in CA

Practice address

11234 Anderson St # MC-1516D
Loma Linda, CA 92354-2804

Phone

(909) 558-4908

NPI assigned

Aug 8, 2016

Sex

Female

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 CA

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Portola Medical Services PCGroup PAC ID 4789970773, 22 clinicians

Riviera Medical CorporationGroup PAC ID 0244311942, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.87 of 100Reported as group

Quality

72.13

Promoting interoperability

80

Improvement activities

40

Cost

77.36

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: terri.granillo.1@15000.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 and National Provider Directory roles.

• Portola Medical Services PC

  • Urgent Care Clinic/Center
  • Lake Forest, CA
  • NPI 1871962076

  CA

  Medicare reassignment Care Compare group
• Riviera Medical Corporation

  • Family Medicine Physician
  • Newport Beach, CA
  • NPI 1225224389

  CA

  Medicare reassignment Care Compare group
• Centinela Freeman Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Inglewood, CA
  • NPI 1528333101

  CA

  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542

  CA

  Medicare reassignment
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917

  CA

  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • Redlands, CA
  • NPI 1619926771
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • Highland, CA
  • NPI 1689624991
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Body Imaging Physician
  • Rialto, CA
  • NPI 1700495363
  NPD
• Cypress Urgent Care, Inc

  • Urgent Care Clinic/Center
  • Cypress, CA
  • NPI 1881836989
  NPD (past)

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1922552819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST # MC-1516D",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST # MC-1516D",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 N Sepulveda Blvd",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Manhattan Beach",
            "state": "CA",
            "postal_code": "902666861",
            "country_code": "US",
            "telephone_number": "310-698-5458",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25333 Barton Road",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923543130",
            "country_code": "US",
            "telephone_number": "909-558-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANILLO",
        "first_name": "TERRI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Beth Gow
• Prashanth Gowda, M.D.
• Gowest Transportation LLC
• Elizabeth Grace, PSYD
• Jeff T Grange, M.D.
• Casey R Graves, MD
• Lauren H. Grawert, MD
• Austin Lance Gray, MD
• Devin Gray
• Richard Jerome Gray, DDS

• All providers in Loma Linda, CA
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.