MARK E GRANDON PA-C NPI 1386683852

NPI Information

  • NPI: 1386683852
  • Provider Name: MARK E GRANDON, PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3 AUDUBON PLAZA DR
    SUITE 560
    LOUISVILLE, KY
    ZIP 40217
  • Phone: (502) 636-8004

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NPI Details

Mark E Grandon, PA-C is a surgical physician assistant in Louisville, KY with 34 years of experience. Mark E Grandon, PA-C NPI is 1386683852. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3 AUDUBON PLAZA DR
SUITE 560
LOUISVILLE, KY
ZIP 40217-319
Phone: (502) 636-8004
Fax: (502) 636-8384

The NPI 1386683852 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Harvest of vein using an endoscope (HCPCS:33508)
  • Coronary artery bypass using artery graft, 1 graft (HCPCS:33533)
  • Extensive reconstruction of upper heart chamber and alteration of electrical pathway using an endoscope (HCPCS:33266)
  • Coronary artery bypass using vein or artery graft, 3 grafts (HCPCS:33519)
  • Coronary artery bypass using vein or artery graft, 2 grafts (HCPCS:33518)
  • Coronary artery bypass graft (CABG) (HCPCS:NAN07)

The enumeration date for this NPI number is 6/6/2006 and was last updated on 7/9/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgicalPA155KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000000689934OTHERKENTUCKYANTHEM - CTS
21299470001OTHERKENTUCKYPTAN
3S04680MEDICARE UPINKENTUCKY
4P400031960MEDICARE PINKENTUCKY
595001558MEDICAIDKENTUCKY
6121030OTHERKENTUCKYSIHO - CTS
70620410MEDICARE PINKENTUCKY
850032501OTHERKENTUCKYPASSPORT/PASSPORT ADVANTAGE - CTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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