1. Home
  2. Directory
  3. California
  4. Roseville
  5. Dermatology
  6. NPI Profile

DR. KONSTANTIN VLADIMIR GRIGORYAN M.D.
NPI 1881076313
Dermatology - MOHS-Micrographic Surgery in Roseville, CA

Active since June 21, 2015PECOS EnrolledAccepts Medicare Assignment
2261 DOUGLAS BLVD, ROSEVILLE, CA 95661(916) 791-0920(916) 797-4767 Get Directions Write a Review

NPPES record last updated: September 30, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 11, 2022, Dec 22, 2017 (2 updates tracked since 2017).

About Dr. Konstantin Vladimir Grigoryan M.d. NPPES

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

DR. KONSTANTIN VLADIMIR GRIGORYAN M.D. (NPI 1881076313) is an individual mohs-micrographic surgery provider in Roseville, California, licensed in California (A169957) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1881076313
Entity TypeIndividualMale
Primary Taxonomy207ND0101X
Provider Legal NameDR. KONSTANTIN VLADIMIR GRIGORYANCredential: M.D.
Location Address2261 DOUGLAS BLVDRoseville, CA 95661-3831
Mailing AddressPo Box 255228Sacramento, CA 95865-5228 · (800) 470-0071 · Fax (916) 854-6769
Phone(916) 791-0920
Fax(916) 797-4767
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateJune 21, 2015
Last NPPES UpdateSeptember 30, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2025
✔ NPI 1881076313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in CA · A169957
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Also ListedDermatologyTaxonomy 207N00000X · License 60753 (MN)
2261 DOUGLAS BLVD, Roseville, CA 95661
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1330 Brookline AveBoston, MA 02215-5400 · Phone (617) 667-7000
Location 210535 Hospital WayMather, CA 95655-4200 · Phone (916) 843-7000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Konstantin Vladimir Grigoryan M.d. 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.

PECOS PAC ID345533881
PECOS Enrollment IDI20250925004024
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 Konstantin Grigoryan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sutter Medical Foundation
13 mi
Diagnostic Radiology
2800 L ST FL 7
Sacramento, CA 95816
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Sutter Valley Medical Foundation
  • 3,056 clinicians in this Medicare group
NPI 1942524095 (916) 731-7857

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95661 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$75.03 typical visit price
range $19.88 – $148.15
Typical copayment $18.75 (range $4.97 – $37.03)
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 20

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

DR. MARY PATRICIA LIST MD
Dermatology
2261 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 797-4766
OLIVIA HOANG-KELADA M.D.
Pediatrics
2261 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 783-7109
ELVEEN KAUR MANN MD
Family Medicine
2261 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 791-0900
VICTOR ORLANDO BONILLA MD, FACC
Internal Medicine (Cardiovascular Disease)
2261 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 783-7109
DR. BARBARA FEBBO-WILSON M.D.
Internal Medicine
2261 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 783-7109
DR. ALLISON DANIELLE DEHART-MARSH DO
Family Medicine
2261 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 791-0900
DR. WILLIAM JORNLIN MD
Family Medicine
2261 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 783-7109
YUNLI ZHENG M.D
Internal Medicine
2261 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 783-7109

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 Konstantin Grigoryan's NPI number?

The NPI number for Konstantin Grigoryan is 1881076313. It was assigned to this individual provider in the NPPES registry on June 21, 2015.

Where is Konstantin Grigoryan located?

Konstantin Grigoryan practices at 2261 Douglas Blvd, Roseville, CA 95661. The listed phone number is (916) 791-0920.

What is Konstantin Grigoryan's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Konstantin Grigoryan enrolled in Medicare?

Yes. Konstantin Grigoryan 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.

Which organization bills Medicare for Konstantin Grigoryan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Konstantin Grigoryan reassigns Medicare benefits to Sutter Medical Foundation (Sacramento, CA). 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 Konstantin Grigoryan'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 Konstantin Grigoryan was last updated on September 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.