Mikayla Jenny Granata, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2063 Issued in NH

Practice address

738 Hooksett Rd
Manchester, NH 03104-2617

Phone

(603) 384-3900

NPI assigned

Apr 27, 2023

Last updated

Jun 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mikayla Jenny Konecny Former name

Medicare fee-for-service enrollment

Enrolled in NH, MA, ME3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Convenientmd - FFS UC LLCGroup PAC ID 5193186492, shared by 3 NPIs, 397 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Nashua, NH
  • NPI 1851082291
  Medicare reassignment
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Ellsworth, ME
  • NPI 1780375220
  Medicare reassignment
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Worcester, MA
  • NPI 1790528628
  Medicare reassignment
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Windham, NH
  • NPI 1336830785
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Weymouth, MA
  • NPI 1053002436
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Brunswick, ME
  • NPI 1154012698
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Sturbridge, MA
  • NPI 1386526192
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Manchester, NH
  • NPI 1952092397
  NPD (past)
• Convenientmd LLC

  • Urgent Care Clinic/Center
  • Manchester, NH
  • NPI 1427729516
  NPD (past)

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1952099962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 HOOKSETT RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042617",
            "telephone_number": "603-384-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Dobson Way",
            "address_purpose": "LOCATION",
            "city": "Merrimack",
            "state": "NH",
            "postal_code": "030544340",
            "country_code": "US",
            "telephone_number": "603-471-6069",
            "fax_number": "603-471-6068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANATA",
        "first_name": "MIKAYLA",
        "middle_name": "JENNY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-27",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "2063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKAYLA",
            "last_name": "KONECNY",
            "middle_name": "JENNY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sheena Gradzewicz, LICSW
• Ellen Ann Graening, ARNP
• Jessica Graff, BS
• William Graff, M.D.
• Kelly Jean Graham
• Steven Roy Grandgeorge, MD
• Stephanie Grandmont, RN
• Granite Community Living LLC
• Granite House of Help
• Granite House of Help LLC

• Physician Assistant in Manchester, NH
• Providers in Manchester, NH by specialty
• Physician Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.