Individual provider Active NPI

Justin N Grammy, DO

  • Hospitalist Physician
  • San Luis Obispo, CA
National Provider Identifier
1003254483
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
16620 Issued in CA
Practice address
1428 Phillips LN Ste 203
San Luis Obispo, CA 93401-2551
Phone
(805) 543-4407
Fax
(805) 543-4587
NPI assigned
Jun 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS018634 PA
Internal Medicine Physician 207R00000X 16620 CA
Hospitalist Physician 208M00000X 16620 CA Primary

Addresses

Primary practice location

1428 Phillips LN Ste 203
San Luis Obispo, CA 93401-2551

Mailing address

PO Box 12460
San Luis Obispo, CA 93406-2460
Phone (805) 543-4407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180901000074 CA Practitioner - Internal Medicine 3274804752 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Coast Chest Consultants, a Medical CorporationGroup PAC ID 6800877101, 8 clinicians

Practice addresses (Care Compare)

1010 Murray Ave
San Luis Obispo, CA 93405-1806
Phone (805) 543-4407

1428 Phillips LN
Suite 203
San Luis Obispo, CA 93401-2551
Phone (805) 543-4407

1911 Johnson Ave
San Luis Obispo, CA 93401-4131
Phone (805) 543-4407

Hospital & facility affiliations

  • French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232
  • Adventist Health Sierra Vista Hospital, San Luis Obispo, CA, CCN 050506
  • Adventist Health Twin Cities Hospital, Templeton, CA, CCN 050633
  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
16620CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Intensivists PC Current Accepting new patients
Barton Medical Foundation CurrentSince Jul 1, 2024 Accepting new patients
Cep America - Intensivists PC CurrentSince Jul 16, 2018 Accepting new patients
Central Coast Chest Consultants a Medical Corporation Internal Medicine CurrentSince Oct 1, 2021 Accepting new patients
Cep America - Intensivists PC CurrentSince Jul 16, 2018 Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000

1050 Linden Ave
Long Beach, CA 90813
Phone (562) 491-9000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1428 Phillips Ln
Ste 203
Sn Luis Obisp, CA 93401
Phone (805) 439-1797

2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420

2074 Lake Tahoe Blvd
Ste 4
South Lake Tahoe, CA 96150
Phone (530) 543-5554

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1003254483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12460",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934062460",
            "telephone_number": "805-543-4407",
            "fax_number": "805-543-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 PHILLIPS LN STE 203",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012551",
            "telephone_number": "805-543-4407",
            "fax_number": "805-543-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMMY",
        "first_name": "JUSTIN",
        "middle_name": "N",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-07",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS018634",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "16620",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "16620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.