CARLY COOK GRANATA PA-C
NPI 1396219408
Physician Assistant in Mitchellville, MD

Active since January 11, 2019PECOS Enrolled
10236 LAKE ARBOR WAY, MITCHELLVILLE, MD 20721(240) 436-2840 Get Directions Write a Review

NPPES record last updated: June 10, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 10, 2022, Mar 19, 2020, Jan 11, 2019 (3 updates tracked since 2019).

About Carly Cook Granata Pa-c NPPES

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

CARLY COOK GRANATA PA-C (NPI 1396219408) is an individual physician assistant in Mitchellville, Maryland, licensed in Virginia (0110007055) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1396219408
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCARLY COOK GRANATACredential: PA-C
Location Address10236 LAKE ARBOR WAYMitchellville, MD 20721-3113
Mailing Address10236 Lake Arbor WayMitchellville, MD 20721-3113 · (404) 362-8402
Sole ProprietorYes
Enumeration DateJanuary 11, 2019
Last NPPES UpdateJune 10, 20223 updates tracked since enumeration
NPPES CertifiedMay 4, 2022
NPI 1396219408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses Licensed in VA · 0110007055 Licensed in MD · C0008389
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
10236 LAKE ARBOR WAY, Mitchellville, MD 20721

Other Names 1

Former Name (1)Carly Jane Cook Pa-c

Secondary Practice Locations 2

Location 137 Glendale CtTroutville, VA 24175-6538 · Phone (540) 355-1688
Location 24901 Brambleton AveRoanoke, VA 24018-4149 · Phone (540) 777-4000 · Fax (540) 777-7007

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Carly Cook Granata Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20721 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

Social Worker (Clinical)
10236 LAKE ARBOR WAY
BOWIE, MD 20721
Clinic/Center (Urgent Care)
10236 LAKE ARBOR WAY
BOWIE, MD 20721

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 Carly Granata's NPI number?

The NPI number for Carly Granata is 1396219408. It was assigned to this individual provider in the NPPES registry on January 11, 2019. The provider is also known as Carly Jane Cook Pa-C.

Where is Carly Granata located?

Carly Granata practices at 10236 Lake Arbor Way, Mitchellville, MD 20721. The listed phone number is (240) 436-2840.

What is Carly Granata's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Carly Granata enrolled in Medicare?

Yes. Carly Granata is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Carly Granata was last updated on June 10, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.