Individual provider Active NPI

Alexander Grell, PA-C

  • Physician Assistant
  • Greeley, CO
National Provider Identifier
1245636737
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4167 Issued in CO
Practice address
6767 West 29TH Street
2ND Floor
Greeley, CO 80634
Phone
(970) 652-2433
Fax
(970) 652-2252
NPI assigned
Nov 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4167 CO Primary

Addresses

Primary practice location

6767 West 29TH Street
2ND Floor
Greeley, CO 80634

Mailing address

6767 W 29TH Street
2ND Floor
Greeley, CO 80634-5474
Phone (970) 652-2433

Other practice location 1

1010 A St
Greeley, CO 80631
Phone (970) 313-0400

Other identifiers 1

IdentifierTypeStateIssuer
76103510MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20150202001622 CO Practitioner - Physician Assistant 7416272034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

4617 W 20TH St
Unit a Select PT
Greeley, CO 80634-3207
Phone (970) 352-9022

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

Hospital & facility affiliations

  • Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Nov 18, 2019 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

6767 29th St
#2
Greeley, CO 80634

6767 29th St
Fl 2
Greeley, CO 80634
Phone (970) 652-2433

6767 29th St
Fl 3
Greeley, CO 80634
Phone (970) 652-2801

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 2

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 4

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": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1245636737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 W 29TH STREET",
            "address_2": "2ND FLOOR",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345474",
            "telephone_number": "970-652-2433",
            "fax_number": "970-652-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 WEST 29TH STREET",
            "address_2": "2ND FLOOR",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-652-2433",
            "fax_number": "970-652-2252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 A St",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "80631",
            "country_code": "US",
            "telephone_number": "970-313-0400",
            "fax_number": "970-313-0404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRELL",
        "first_name": "ALEXANDER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-10",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "4167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76103510",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.