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ANTON GRYAZNOV MD, PHD
NPI 1558858720
Student in an Organized Health Care Education/Training Program in Baltimore, MD

Active since April 13, 2018PECOS Enrolled
22 S GREENE ST, BALTIMORE, MD 21201(410) 328-8667 Get Directions Write a Review

NPPES record last updated: May 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 11, 2022, Apr 13, 2018 (2 updates tracked since 2018).

About Anton Gryaznov Md, Phd NPPES

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

ANTON GRYAZNOV MD, PHD (NPI 1558858720) is an individual student in an organized health care education/training program in Baltimore, Maryland and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558858720
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameANTON GRYAZNOVCredential: MD, PHD
Location Address22 S GREENE STBaltimore, MD 21201-1590
Mailing Address11 Winding TrlMiddlebury, CT 06762-2938 · (781) 697-7522
Phone(410) 328-8667
Sole ProprietorYes
Enumeration DateApril 13, 2018
Last NPPES UpdateMay 11, 20222 updates tracked since enumeration
NPPES CertifiedMay 11, 2022
✔ NPI 1558858720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
22 S GREENE ST, Baltimore, MD 21201
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Anton Gryaznov Md, Phd 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.

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.

DR. LEONARD ANANG SOWAH M.D.
Internal Medicine
22 S GREENE ST
BALTIMORE, MD 21201
Baltimore City (410) 706-4619
VISHAL BHATNAGAR MD
Student in an Organized Health Care Education/Training Program
22 S GREENE ST, MEDICINE, N3E09
BALTIMORE, MD 21201
Baltimore City (410) 328-6110
NANCE J FOX P.A.-C
Physician Assistant (Medical)
22 S GREENE ST, G2K36
BALTIMORE, MD 21201
Baltimore City (410) 328-1170
HILARY TAMARA WOLF MD
Pediatrics (Adolescent Medicine)
22 S GREENE ST
BALTIMORE, MD 21201
Baltimore City (410) 328-7373
MS. LINDSAY BREAM O'MEARA CRNP
Nurse Practitioner (Acute Care)
22 S GREENE ST, SUITE S4D07
BALTIMORE, MD 21201
Baltimore City (410) 328-3365
NORA T OLIVER M.D., M.P.H.
Student in an Organized Health Care Education/Training Program
22 S GREENE ST, N3E09
BALTIMORE, MD 21201
Baltimore City (410) 328-5756
SHOSHANA JO WEINER
Internal Medicine
22 S GREENE ST
BALTIMORE, MD 21201
Baltimore City (617) 214-1332
JENNA VANLIERE CANZONIERO M.D.
Internal Medicine
22 S GREENE ST, N3E09
BALTIMORE, MD 21201
Baltimore City (410) 328-5756

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 Anton Gryaznov's NPI number?

The NPI number for Anton Gryaznov is 1558858720. It was assigned to this individual provider in the NPPES registry on April 13, 2018.

Where is Anton Gryaznov located?

Anton Gryaznov practices at 22 S Greene St, Baltimore, MD 21201. The listed phone number is (410) 328-8667.

What is Anton Gryaznov's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Anton Gryaznov enrolled in Medicare?

Yes. Anton Gryaznov is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Anton Gryaznov was last updated on May 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.