Individual provider Active NPI

James Grinols, MD

  • Pediatrics Physician
  • Saint Paul, MN
National Provider Identifier
1033137245
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35399 Issued in MN
Practice address
1020 Bandana Blvd W
Saint Paul, MN 55108-5107
Phone
(651) 641-7021
Fax
(651) 641-7151
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35399 MN Primary

Addresses

Primary practice location

1020 Bandana Blvd W
Saint Paul, MN 55108-5107

Mailing address

1021 Bandana Blvd E
Suite 200
Saint Paul, MN 55108-5113
Phone (651) 642-2700

Other identifiers 1

IdentifierTypeStateIssuer
786716600MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110502000140 WI Practitioner - Pediatric Medicine 6204019219 Reassigns benefits to 1 organization
I20190422000746 VA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 6204019219 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince May 4, 2020 Accepting new patients
Privia Medical Group, LLC Pediatrics CurrentSince May 4, 2020 Accepting new patients
Mercy Health System Corporation CurrentSince Mar 12, 2018 Accepting new patients
Mercy Health System Corporation CurrentSince Mar 12, 2018 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients
The Duluth Clinic, LTD. Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

8644 Sudley Rd
#220
Manassas, VA 20110

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033137245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 BANDANA BLVD E",
            "address_2": "SUITE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085113",
            "telephone_number": "651-642-2700",
            "fax_number": "651-642-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 BANDANA BLVD W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085107",
            "telephone_number": "651-641-7021",
            "fax_number": "651-641-7151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINOLS",
        "first_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "35399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "786716600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.