Individual provider Active NPI

Jennifer Quick Grieve, DO

  • Emergency Medicine Physician
  • Waukesha, WI
National Provider Identifier
1093075475
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01073139A Issued in IN
Practice address
725 American Ave
Suite 5
Waukesha, WI 53188-5031
Phone
(262) 928-2475
NPI assigned
May 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01073139A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

725 American Ave
Suite 5
Waukesha, WI 53188-5031

Mailing address

725 American Ave Ste 5
Waukesha, WI 53188-5031

Other identifiers 2

IdentifierTypeStateIssuer
20101630MedicaidIN
201101630MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20150617002961 WI Practitioner - Emergency Medicine 2668611583 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medical Associates LLPGroup PAC ID 0648242065, 17 clinicians

Practice addresses (Care Compare)

725 American Ave
Suite 5
Waukesha, WI 53188-5031
Phone (262) 928-2475

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Associates LLP Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
Lake Country Emergency Physicians Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Indiana University Health Care Associates, Inc Past Accepting new patients

Locations

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

725 American Ave
Ste 5
Waukesha, WI 53188
Phone (262) 544-2384

725 American Ave
#5
Waukesha, WI 53188
Phone (262) 928-2475

Interoperability endpoints

  • Direct secure messaging: jquick33392@direct.phci.org

Organizations & group practices 3

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 1

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": "1337472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1093075475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE STE 5",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE",
            "address_2": "SUITE 5",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031",
            "telephone_number": "262-928-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIEVE",
        "first_name": "JENNIFER",
        "middle_name": "QUICK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-20",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01073139A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20101630",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201101630",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.