Active NPI
Samantha J Grigg, PA-C
- Physician Assistant
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4170-23
- Practice address
- 1821 S Webster Ave
Green Bay, WI 54301-2253 - Phone
- (920) 496-4700
- NPI assigned
- Aug 25, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4170-23 | WI | Primary |
Addresses
Primary practice location
1821 S Webster Ave
Green Bay, WI 54301-2253
Mailing address
PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100070759 | Medicaid | WI |
Other names 1
- Samantha J Iwen
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sgrigg201595@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | sgrigg270869@ewd.direct.hshs.org | Direct |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1821 S Webster Ave
Green Bay, WI 54301-2253
Phone (920) 496-4700
1843 Michigan St
Sturgeon Bay, WI 54235-1007
Phone (920) 746-1060
323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone (920) 743-5566
3860 Monroe Rd
De Pere, WI 54115-8399
Phone (920) 496-4700
835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700
Hospital & facility affiliations
- St Vincent Hospital
- St Marys Hospital Medical Ctr
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4170-23 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Current | Accepting new patients | |
| Door County Memorial Hospital | Current | Accepting new patients | |
| Door County Memorial Hospital | Current | Accepting new patients | |
| St Nicholas Hospital-Sisters of the Third Order of St Francis | Current | Accepting new patients | |
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Current | Accepting new patients | |
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Past | Accepting new patients |
Locations
1821 S Webster Ave
Green Bay, WI 54301
Phone (920) 431-1850
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710
911 Green Bay Rd
Ste 103
Sturgeon Bay, WI 54235
Phone (920) 743-5566
323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566
Interoperability endpoints
- sgrigg201595@direct.myadvocateaurora.org
Organizations & group practices 7
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.
-
- Critical Access Hospital
- Sturgeon Bay, WI
- NPI 1093743874
-
- General Practice Physician
- Green Bay, WI
- NPI 1285613638
-
- Internal Medicine Physician
- Sheboygan, WI
- NPI 1275799413
-
- Rural Health Clinic/Center
- Sturgeon Bay, WI
- NPI 1326748104
-
- Internal Medicine Physician
- Sheboygan, WI
- NPI 1447737762
-
- Durable Medical Equipment & Medical Supplies
- Green Bay, WI
- NPI 1245042530
-
- Gynecologic Oncology Physician
- Green Bay, WI
- NPI 1316991169
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1649246877
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1114908001
-
- Hematology & Oncology Physician
- Sheboygan, WI
- NPI 1831784636
Hospital
-
- Hematology & Oncology Physician
- Green Bay, WI
- NPI 1184004236
Hospital
-
- Hematology & Oncology Physician
- Oconto Falls, WI
- NPI 1750760740
Hospital
-
- Hematology & Oncology Physician
- Sturgeon Bay, WI
- NPI 1760861751
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1134646557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19070",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543079070",
"telephone_number": "920-496-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1821 S WEBSTER AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543012253",
"telephone_number": "920-496-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIGG",
"first_name": "SAMANTHA",
"middle_name": "J",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-25",
"last_updated": "2024-05-23",
"certification_date": "2024-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "4170-23",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100070759",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sgrigg201595@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2253 W Mason St",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543034706",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2253 W Mason St",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543034706",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sgrigg270869@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "1821 S Webster Ave",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543012253",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SAMANTHA",
"last_name": "IWEN",
"middle_name": "J",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.