ETHAN D GRANGER
NPI 1457048324
Physician Assistant in La Jolla, CA
About Ethan D Granger NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN D GRANGER (NPI 1457048324) is an individual physician assistant in La Jolla, California, licensed in California (PA67139) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS, maintains a secondary practice location in Albuquerque, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ethan D Granger is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92037 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
LA JOLLA, CA 92037
LA JOLLA, CA 92037
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 Ethan Granger's NPI number?
The NPI number for Ethan Granger is 1457048324. It was assigned to this individual provider in the NPPES registry on April 20, 2023.
Where is Ethan Granger located?
Ethan Granger practices at 9300 Campus Point Dr, La Jolla, CA 92037. The listed phone number is (800) 926-8273.
What is Ethan Granger's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Ethan Granger enrolled in Medicare?
Yes. Ethan Granger is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
What insurance does Ethan Granger accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Ethan Granger as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Ethan Granger was last updated on January 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.
# Ethan D Granger · NPI 1457048324
Physician Assistant physician in La Jolla, California. Individual provider, active in the CMS NPPES registry since April 20, 2023.
## Identity
- **NPI:** 1457048324 (Entity type: Individual)
- **Enumerated:** April 20, 2023
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** PA67139 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 9300 CAMPUS POINT DR, La Jolla, CA 92037-1300
- **Phone:** (800) 926-8273
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** January 28, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1457048324) · Data from the CMS NPPES public registry.