Individual provider Active NPI

Grant Scott Geisler

  • Physician Assistant
  • Urbana, IL
National Provider Identifier
1154079721
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085011000 Issued in IL
Practice address
611 W Park St
Urbana, IL 61801-2501
Phone
(217) 383-3210
NPI assigned
Mar 14, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 5894-23 WI
Physician Assistant 363A00000X 085011000 IL Primary

Addresses

Primary practice location

611 W Park St
Urbana, IL 61801-2501

Mailing address

611 W Park St
Fapc
Urbana, IL 61801-2500

Other practice location 1

16650 W Bluemound Rd Ste 200
Brookfield, WI 53005-5959
Phone (262) 827-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 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
I20220920002726 WI Practitioner - Physician Assistant 7315322831 Reassigns benefits to 2 organizations
I20250224000075 IL Practitioner - Physician Assistant 7315322831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085011000ILMDPhysician Assistant
5894-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Single Specialty CurrentSince Jul 29, 2022 Accepting new patients
Carle Health Care Incorporated Single Specialty CurrentSince Feb 17, 2025 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Single Specialty CurrentSince Jul 29, 2022 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

16650 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 827-9200

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Interoperability endpoints

  • Direct secure messaging: ggeislerpa438077@carlehiedirect.net

Organizations & group practices 5

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 2

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": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1154079721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012501",
            "telephone_number": "217-383-3210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16650 W Bluemound Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530055959",
            "country_code": "US",
            "telephone_number": "262-827-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEISLER",
        "first_name": "GRANT",
        "middle_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-14",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "5894-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085011000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.