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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MARK GRANDA
NPI 1366374563
Counselor - Addiction (Substance Use Disorder) in San Antonio, TX

Active since June 01, 2026PECOS Enrolled
1055 ADA ST, SAN ANTONIO, TX 78223(210) 358-5515(210) 358-5530 Get Directions Write a Review

NPPES record last updated: September 18, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 18, 2026, Jun 1, 2026 (2 updates tracked since 2026).

About Mark Granda NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK GRANDA (NPI 1366374563) is an individual addiction (substance use disorder) provider in San Antonio, Texas, licensed in Texas (17557) and active in the NPI registry since June 2026. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1366374563
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMARK GRANDA
Location Address1055 ADA STSan Antonio, TX 78223-1703
Mailing Address1055 Ada StSan Antonio, TX 78223-1703 · (210) 358-5515 · Fax (210) 358-5530
Phone(210) 358-5515
Fax(210) 358-5530
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateJune 1, 2026
Last NPPES UpdateSeptember 18, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 18, 2026
✔ NPI 1366374563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in TX · 17557
1055 ADA ST, San Antonio, TX 78223
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark Granda is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9234693862
PECOS Enrollment IDI20260714003851
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mark Granda reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Medicine Associates
4.4 mi
Family Medicine
903 W MARTIN ST # MS 49-2
San Antonio, TX 78207
  • Reassigned Medicare billing, Texas enrollment
  • 1,129 clinicians in this Medicare group
NPI 1245313329 (210) 358-3401

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAY PETER MANGULABNAN MD
Internal Medicine
1055 ADA ST
SAN ANTONIO, TX 78223
Bexar County (210) 358-5515
BRETT STEELMAN
Physician Assistant
1055 ADA ST
SAN ANTONIO, TX 78223
Bexar County (210) 358-5515
DR. SHARIF EUSUFZAI M.D., PHD
Internal Medicine (Geriatric Medicine)
1055 ADA ST, SOUTH BEXAR VA OUT PATIENT CLINIC
SAN ANTONIO, TX 78223
Bexar County (210) 358-5682
DR. TERESA M. RUIZ M.D.
Pediatrics
1055 ADA ST
SAN ANTONIO, TX 78223
Bexar County (210) 358-5515
MRS. JUSTINE LEE HUDSON PA-C
Physician Assistant
1055 ADA ST
SAN ANTONIO, TX 78223
Bexar County (210) 358-5515
CHRISTINA AILEEN KRUSE PHARMD
Pharmacist
1055 ADA ST
SAN ANTONIO, TX 78223
Bexar County (210) 358-5534
BRIDGET SEDANO HAGGERTY
Nurse Practitioner (Family)
1055 ADA ST
SAN ANTONIO, TX 78223
Bexar County (210) 358-5515
BEXAR COUNTY HOSPITAL DISTRICT
Pharmacy (Community/Retail Pharmacy)
1055 ADA ST
SAN ANTONIO, TX 78223
Bexar County (210) 358-5534

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 Mark Granda's NPI number?

The NPI number for Mark Granda is 1366374563. It was assigned to this individual provider in the NPPES registry on June 1, 2026.

Where is Mark Granda located?

Mark Granda practices at 1055 Ada St, San Antonio, TX 78223. The listed phone number is (210) 358-5515.

What is Mark Granda's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Mark Granda enrolled in Medicare?

Yes. Mark Granda is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mark Granda's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Granda reassigns Medicare benefits to Community Medicine Associates (San Antonio, TX). The 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 Mark Granda's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mark Granda was last updated on September 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 36 days 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.