Jordan Grosdidier

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

101 7TH St SW
Orange City, IA 51041-1923

Phone

(712) 707-7000

NPI assigned

Mar 15, 2023

Last updated

Mar 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera Queen of PeaceGroup PAC ID 9335050806, 122 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avera Queen of Peace Hospital, Mitchell, SD, CCN 431340

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jordan.grosdidier@avera.sdhealthlink.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.

• Avera Queen of Peace

  dba Avera Queen of Peace Hospital

  • Critical Access Hospital
  • Mitchell, SD
  • NPI 1992466635
  Medicare reassignment Care Compare group NPD
• Avera Queen of Peace

  dba AMG Hospitalists Mitchell

  • Hospitalist Physician
  • Mitchell, SD
  • NPI 1205359031
  Medicare reassignment
• Avera Queen of Peace

  dba Avera Family Medicine Mitchell/AveraNOW

  • Family Medicine Physician
  • Mitchell, SD
  • NPI 1124308010
  NPD
• Avera Queen of Peace

  dba Avera Weskota Memorial Medical Center

  • Critical Access Hospital
  • Wessington Springs, SD
  • NPI 1316942204
  NPD
• Avera Queen of Peace

  dba Avera Medical Group Oncology & Hematology Mitchell

  • Hematology & Oncology Physician
  • Mitchell, SD
  • NPI 1568986040
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Avera Queen of Peace

  dba Avera Queen of Peace Hospital

  • Critical Access Hospital
  • Mitchell, SD
  • NPI 1992466635
  Care Compare affiliation

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1144921206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "ALTON",
            "state": "IA",
            "postal_code": "510030009",
            "telephone_number": "605-933-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 7TH ST SW",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411923",
            "telephone_number": "712-707-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSDIDIER",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly J Gilmore, MS, RD, LD
• David L Gohman, O.D.
• Kimberly Goslinga, ARNP
• Meghan Grassel, MD
• Gina A Greene, ATC
• Jonathan Groskreutz, PT
• Douglas L Grossmann, PA-C
• Jonathan C Grossmann, M.D.
• Jameson Guthmiller, M.D.
• Katherine Marie Hafner

• Physician Assistant in Orange City, IA
• Providers in Orange City, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.