EDITH GRANNUM MD PC
NPI 1104003235
Family Medicine in Rochester, NY
About Edith Grannum Md Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EDITH GRANNUM MD PC (NPI 1104003235) is a healthcare organization registered as a family medicine in Rochester, New York and active in the NPI registry since January 2008. The organization lists Edith Gwendoline Grannum, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Edith Grannum Md Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Edith Grannum MD PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Edith Grannum MD PC's NPI number?
The NPI number for Edith Grannum MD PC is 1104003235. It was assigned to this organization in the NPPES registry on January 31, 2008.
Where is Edith Grannum MD PC located?
Edith Grannum MD PC is located at 1815 S Clinton Ave, Rochester, NY 14618. The listed phone number is (585) 233-1366.
What is Edith Grannum MD PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Edith Grannum MD PC enrolled in Medicare?
Yes. Edith Grannum MD PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Edith Grannum MD PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Edith Grannum MD PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Edith Grannum MD PC was last updated on March 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Edith Grannum Md Pc · NPI 1104003235
Family Medicine organization in Rochester, New York. Organization record, active in the CMS NPPES registry since January 31, 2008.
## Identity
- **NPI:** 1104003235 (Entity type: Organization)
- **Enumerated:** January 31, 2008
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Edith Grannum, MEDICAL DIRECTOR
## Practice location
- **Address:** 1815 S CLINTON AVE, Rochester, NY 14618-5720
- **Phone:** (585) 233-1366
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 19, 2008
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Source: [NPI Profile](https://npiprofile.com/npi/1104003235) · Data from the CMS NPPES public registry.