Alexander Grantsaris

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

28197039A Issued in IN

Practice address

600 Grant St
Gary, IN 46402-6001

Phone

(219) 886-4289

NPI assigned

Aug 31, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

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

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Providence Health & Services Mt

  • Rehabilitation Hospital Unit
  • Missoula, MT
  • NPI 1144319138
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Mt

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1215222617
  NPD
• Providence Health & Services Mt

  • Cardiovascular Disease Physician
  • Butte, MT
  • NPI 1538394267
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services Mt

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1023032588
  Care Compare affiliation
• Providence Health & Services Mt

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1326483587

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Anatomic Pathology & Clinical Pathology Physician
  • Missoula, MT
  • NPI 1366185928

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Psychiatric Hospital Unit
  • Missoula, MT
  • NPI 1619058302
  Care Compare affiliation

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1922554831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3662 KINGSWAY DR",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078936",
            "telephone_number": "219-308-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRANT ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464026001",
            "telephone_number": "219-886-4289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3075 N Reserve St Ste Q",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598081390",
            "country_code": "US",
            "telephone_number": "406-327-1850",
            "fax_number": "406-327-1875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANTSARIS",
        "first_name": "ALEXANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "115857",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28197039A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina I Grady, PTA
• Destine Graham
• Terryon Gransberry
• Antwana Grant
• Chereese Alexandria Grant
• Kenyahtta Gray
• Great Expectations ABA LLC
• Great Lakes Adult Living
• Great Lakes Pulmonary & Sleep Associates, Inc
• De'Loria Green

• Family Nurse Practitioner in Gary, IN
• Providers in Gary, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.