Brian E Granvall, PA-C is a medicare enrolled "Radiology - Diagnostic Radiology" in Boise, Idaho. His current practice location is
190 E Bannock St, Boise, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 381-2094.
Brian E Granvall is licensed to practice in Idaho (license number PA-1042) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1205809852.
Provider's Profile
| Full Name | Brian E Granvall |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 190 E Bannock St, Boise, Idaho |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Brian E Granvall attended and graduated from in
NPI Data:
- NPI Number: 1205809852
- Provider Enumeration Date: 02/13/2006
- Last Update Date: 01/31/2022
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Brian E Granvall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205809852 | NPI | - | NPPES |
| 8326142 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 0110002940 (Virginia) | Secondary |
| 363A00000X | Physician Assistant | PA10004399 (Washington) | Secondary |
| 363A00000X | Physician Assistant | PA 00846 (Oregon) | Secondary |
| 363AS0400X | Physician Assistant - Surgical | C04233 (Maryland) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | PA-1042 (Idaho) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brian E Granvall is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Brian E Granvall, PA-C
Po Box 1108,
Corvallis, OR 97339-1108
Ph: (208) 381-2094 | Brian E Granvall, PA-C
190 E Bannock St,
Boise, ID 83712-6241
Ph: (208) 381-2094 |
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