Jacob Adam Grillo, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

809 W Main St Ste C
Monroe, WA 98272-2172

Phone

(206) 552-0882

NPI assigned

Sep 16, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Conquer Addiction PLLCGroup PAC ID 8325562044, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Physician Assistant

Practice roles

Locations

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.

• Conquer Addiction PLLC

  dba Conquer

  • Multi-Specialty Clinic/Center
  • Monroe, WA
  • NPI 1255001624
  Medicare reassignment Care Compare group NPD Authorized official
• Conquer Addiction PLLC

  dba Conquer

  • Adult Mental Health Clinic/Center
  • Monroe, WA
  • NPI 1689494262
  NPD Authorized official
• Public Hospital District 1 of Snohomish County

  dba EvergreenHealth Monroe

  • General Acute Care Hospital
  • Monroe, WA
  • NPI 1013074061
  Medicare reassignment
• Seattle Pain Relief PLLC

  • Family Medicine Physician
  • Federal Way, WA
  • NPI 1710240841
  Medicare reassignment
• Public Hospital District No 1 of Snohomish County

  dba EvergreenHealth Monroe Recovery Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Monroe, WA
  • NPI 1770614273
  NPD

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1043612575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 W MAIN ST STE C",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982722172",
            "telephone_number": "206-552-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 W MAIN ST STE C",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982722172",
            "telephone_number": "206-552-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLO",
        "first_name": "JACOB",
        "middle_name": "ADAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-16",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lymaris E Gonzalez Amey, LMP
• Graham Jones, D.D.S., M.S.D., P.L.L.C.
• Robert Green, PTA
• Kelly Marie Greiner, LMP
• Margaret Griffin, CMT
• Gumshoe Health, P.S
• Margaret Gustafson, ARNP
• Heather Gutierrez, ARNP
• Christine Michele Halverson, CPC
• Jeffrey D. Hambleton, MD

• Medical Physician Assistant in Monroe, WA
• Providers in Monroe, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.