Brian E Granvall (NPI# 1205809852, PAC ID# 0941282461) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1205809852 |
| PAC ID by PECOS | 0941282461 |
| Professional Enrollment ID | I20130426000241 |
| Full Name | Brian E Granvall |
| Organization Legal Name | BOISE RADIOLOGY GROUP PLLC |
| Address |
895 N 6th St E Mountain Home ID 83647-2207 |
| Phone Number | 2083812094 |
| Gender | M |
| Credential | PA |
| Graduation Year | 2002 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 9638153257 |
| Number of Group Practice Members | 38 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
| 130071 | ST LUKE'S NAMPA MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 190 E Bannock, Boise, ID 83712-6241 | 2083812094 | BOISE RADIOLOGY GROUP PLLC |
| 895 N 6th St E, Mountain Home, ID 83647-2207 | 2083812094 | BOISE RADIOLOGY GROUP PLLC |
| 9850 St Lukes Dr, Nampa, ID 83687-7912 | 2085052017 | BOISE RADIOLOGY GROUP PLLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_076_overall | Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections | 100% | |
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 95% |
| Organization Legal Name | BOISE RADIOLOGY GROUP PLLC |
| Physicians | 15 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven V Marx | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| Michael T Fisher | Diagnostic Radiology | Boise Radiology Group Pllc | 190 E Bannock, Boise, ID 83712-6241 |
| Jeffrey M Pugsley | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| Zachary J Beatty | Diagnostic Radiology | Boise Radiology Group Pllc | 190 E Bannock, Boise, ID 83712-6241 |
| Adam S Maxfield | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| James A Hill | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| Amaya Basta | Diagnostic Radiology | Boise Radiology Group Pllc | 520 S Eagle Rd, Meridian, ID 83642-6308 |
| Daniel D Ririe | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| Michael D Carroll | Diagnostic Radiology | Boise Radiology Group Pllc | 190 E Bannock, Boise, ID 83712-6241 |
| Tara B Anthes | Diagnostic Radiology | Boise Radiology Group Pllc | 520 S Eagle Rd, Meridian, ID 83642-6308 |
| Street Address |
895 N 6TH ST E |
| City | MOUNTAIN HOME |
| State | ID |
| Zip | 83647-2207 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven V Marx | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| Jeffrey M Pugsley | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| Adam S Maxfield | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| James A Hill | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| Daniel D Ririe | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| Nicholas A Lazzaro | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| Barbara A White | Diagnostic Radiology | Boise Radiology Group Pllc | 895 N 6th St E, Mountain Home, ID 83647-2207 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jamie R Knapp | Physician Assistant | St Lukes Clinic-treasure Valley LLC | 840 N 4th, Mountain Home, ID 83647-2137 |
| Timothy M Ruth | Family Medicine | St Lukes Clinic-treasure Valley LLC | 840 N 4th, Mountain Home, ID 83647-2137 |
| Karen A Galvan | General Surgery | St Lukes Clinic-treasure Valley LLC | 840 N 4th, Mountain Home, ID 83647-2137 |
| Lily J Wittich | Family Medicine | St Lukes Clinic-treasure Valley LLC | 840 N 4th, Mountain Home, ID 83647-2137 |
| Joseph W Hoskin | Physician Assistant | St Lukes Clinic-treasure Valley LLC | 840 N 4th, Mountain Home, ID 83647-2137 |
| Mary K Jenks | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 465 Mckenna Dr, Mountain Home, ID 83647-2143 |
| Whitney A Roberts | Physician Assistant | St Lukes Clinic-treasure Valley LLC | 465 Mckenna Dr, Mountain Home, ID 83647-2143 |
| Dennis D Crossley | Family Medicine | St Lukes Clinic-treasure Valley LLC | 465 Mckenna Dr, Mountain Home, ID 83647-2143 |
| Michelle Pehrson | Nurse Practitioner | St Lukes Clinic-treasure Valley LLC | 465 Mckenna Dr, Mountain Home, ID 83647-2143 |
| Michael S Charme | Family Medicine | St Lukes Clinic-treasure Valley LLC | 465 Mckenna Dr, Mountain Home, ID 83647-2143 |
| Find all physicians in zip 83647 | |||
| City | MOUNTAIN HOME |
| Zip Code | 83647 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | MOUNTAIN HOME + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Brian E Granvall.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.