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Elysha Rand Grauman

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305

PECOS Enrollment

This provider is enrolled in PECOS as ELYSHA GRAUMAN.

Based on the most recent information from CMS, provider Elysha Rand Grauman is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1073718714
Provider Type
Individual
Full Name
Grauman, Elysha Rand
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
6/20/2007
Last Updated
2/17/2011

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305

(718) 226-9158

(718) 226-6964

Mailing Location

One Edgewater Street, 6th Floor, Staten Island, NY 10305

(718) 226-4324

(718) 226-1039

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 010433 New York

Provider Identifiers

ID	Description	Issuer
ID 02928527	Description Medicaid	Issuer Unlisted New York

Elysha Rand Grauman

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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Hanna, Catherine

Kelly, Erin Kathleen

Buckley Jamison, Moriah

Serino, Jessica

Otterbeck, Victoria Angela

Sher, Maykl

Becker, Jennifer Mary

Pope-Lydon, Annette

Silfen, Shelley G