DR. DAVID A. GRANOVETTER MD
NPI 1619053121
Psychiatry & Neurology - Addiction Psychiatry in San Jose, CA

Q: What is David Granovetter's NPI number?

The NPI number for David Granovetter is 1619053121. It was assigned to this individual provider in the NPPES registry on October 27, 2006.

Q: What is David Granovetter's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Psychiatry, with taxonomy code 2084P0802X.

Q: When was this NPI record last updated?

The NPPES record for David Granovetter was last updated on March 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since October 27, 2006PECOS Enrolled

6203 SAN IGNACIO AVE STE 110, SAN JOSE, CA 95119(660) 245-2858 Get Directions Write a Review

NPPES record last updated: March 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 12, 2026, Nov 30, 2021 (2 updates tracked since 2021).

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About Dr. David A. Granovetter Md NPPES

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

DR. DAVID A. GRANOVETTER MD (NPI 1619053121) is an individual addiction psychiatry provider in San Jose, California, licensed in California (G67173) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619053121

Entity TypeIndividualMale

Primary Taxonomy2084P0802X

Provider Legal NameDR. DAVID A. GRANOVETTERCredential: MD

Location Address6203 SAN IGNACIO AVE STE 110San Jose, CA 95119-1358

Mailing Address6203 San Ignacio Ave Ste 110San Jose, CA 95119-1358 · (669) 245-2858

Phone(660) 245-2858

Sole ProprietorYes

Enumeration DateOctober 27, 2006

Last NPPES UpdateMarch 12, 20262 updates tracked since enumeration

NPPES CertifiedMarch 12, 2026

✔ NPI 1619053121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Addiction PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0802X

License✔ Licensed in CA · G67173

Definition

Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders.

6203 SAN IGNACIO AVE STE 110, San Jose, CA 95119

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Other Identifiers 1

Medicaid00G671730CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. David A. Granovetter Md 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.

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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.

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