Kristin Marie Groessl, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA61092965 Issued in WA

Practice address

4409 NW Anderson Hill Rd
Silverdale, WA 98383-6807

Phone

(360) 698-6630

Fax

(360) 698-7002

NPI assigned

Nov 15, 2005

Last updated

Dec 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kgroessl644052@fhsce.catholichealth.net

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.

• Advanced Healthcare SC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1154371847
  NPD (past)
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Union Grove, WI
  • NPI 1245440601
  NPD (past)
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD (past)
• Integrated Spine Care, S.C.

  • Orthopaedic Surgery of the Spine Physician
  • Wauwatosa, WI
  • NPI 1245212414
  NPD (past)
• Milwaukee Neurological Institute, SC

  • Neurological Surgery Physician
  • Milwaukee, WI
  • NPI 1992743397

  Surgical

  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1093797250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 NW ANDERSON HILL RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983836807",
            "telephone_number": "360-698-6630",
            "fax_number": "360-698-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 NW ANDERSON HILL RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983836807",
            "telephone_number": "360-698-6630",
            "fax_number": "360-698-7002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12203 Corporate Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530923388",
            "country_code": "US",
            "telephone_number": "262-387-8200",
            "fax_number": "262-387-8271",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12203 Corporate Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530923388",
            "country_code": "US",
            "telephone_number": "262-387-8200",
            "fax_number": "262-387-8271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROESSL",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61092965",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1164-023",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "1164-023",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "56266",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61092965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgroessl644052@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4409 NW Anderson Hill Rd",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983836807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon D Gregory
• Amie Maude Greist, LMHC
• Deborah Griffin, OT
• Mary Elizabeth Griffith
• Michael Griffiths, LMP
• Stefan Mark Groetsch, MD
• Evan Charles Grolley, AU.D.
• Lisa Lorraine Gross, L.M.P.
• Leigha K Gruber
• Michael Ryan Gruner, SLPA

• Surgical Physician Assistant in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.