BRIAN E GRANVALL (PA-C) – Diagnostic Radiology Physician, NPI 1205809852
Diagnostic Radiology Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for BRIAN E GRANVALL (PA-C)
Corvallis Post Office, Southwest Jefferson Avenue, Corvallis, Benton County, Oregon, 97331, United States
CORVALLIS, OR 973391108
Phone: (208) 381-2094
Fax: (208) 381-1791
Type: Mailing
St. Luke's Boise Medical Center, 190, East Bannock Street, Downtown, Boise, Ada County, Idaho, 83712, United States
BOISE, ID 837126241
Phone: (208) 381-2094
Fax: (208) 381-1791
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-09-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130426000241 | I | Physician Assistant | ID | TBD |
| I20200929002000 | I | Physician Assistant | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97339)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | MD | 20610 | Aspiration and/or injection of large joint or joint capsule | 39 | 37 |
| PHYSICIAN ASSISTANT | MD | 36556 | Insertion of central venous catheter for infusion, patient 5 years or older | 13 | 13 |
| PHYSICIAN ASSISTANT | MD | 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 54 | 54 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine, Critical Care (Intensivists), Critical Care (Intensivists), Internal Medicine | FL | |
| Physician Assistant | VT | |
| Internal Medicine | NY | |
| Nurse Practitioner | FL | |
| Pulmonary Disease, Internal Medicine | OK | |
| - | SC | |
| - | VA | |
| Pulmonary Disease, Critical Care (Intensivists) | GA | |
| Internal Medicine, Critical Care (Intensivists) | OR | |
| - | FL |
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