Individual provider Active NPI

Grant W. Robbins, PA-C

  • Physician Assistant
  • Anchorage, AK
National Provider Identifier
1053772392
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
219361 Issued in AK
Practice address
4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone
(907) 729-3300
NPI assigned
Mar 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 219361 AK Primary
Medical Physician Assistant 363AM0700X PA0004580 CO

Addresses

Primary practice location

4320 Diplomacy Dr
Anchorage, AK 99508-5925

Mailing address

7033 E Tudor Rd
Anchorage, AK 99507-1262
Phone (907) 729-6799

Other practice location 1

1400 S Potomac St
#150
Aurora, CO 80012-4528
Phone (303) 306-4321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160324000598 CO Practitioner - Physician Assistant 6608173331 Reassigns benefits to 2 organizations
I20240530002563 TX Practitioner - Physician Assistant 6608173331 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Aleutian Tribes, Inc.Group PAC ID 2860301884, 34 clinicians

Practice addresses (Care Compare)

100 Slocum Dr
King Cove, AK 99612-0100
Phone (907) 497-2311

2105 Main St
Adak, AK 99546-2105
Phone (907) 592-8383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0004580COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Nov 26, 2018 Accepting new patients
Inpatient Consultants of Colorado PC CurrentSince Mar 14, 2016 Accepting new patients
Southcentral Foundation CurrentSince Nov 1, 2024 Accepting new patients
Southcentral Foundation CurrentSince Nov 1, 2024 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Nov 1, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Nov 26, 2018 Accepting new patients
Inpatient Consultants of Colorado, PC Physician Assistant Past Accepting new patients

Locations

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

1400 S Potomac St
Ste 150
Aurora, CO 80012
Phone (720) 307-7246

12250 E Iliff Ave
Ste 300
Aurora, CO 80014
Phone (720) 524-1550

500 Eldorado Blvd
Ste 6300
Broomfield, CO 80021
Phone (303) 272-0803

2000 S Colorado Blvd
Ste 420
Denver, CO 80222
Phone (720) 524-1550

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1053772392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071262",
            "telephone_number": "907-729-6799",
            "fax_number": "907-729-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085925",
            "telephone_number": "907-729-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Potomac St",
            "address_2": "#150",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800124528",
            "country_code": "US",
            "telephone_number": "303-306-4321",
            "fax_number": "720-524-1551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBBINS",
        "first_name": "GRANT",
        "middle_name": "W.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-15",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "219361",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA0004580",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.