Individual provider Active NPI

Carl Russell Griesser, MD

  • Family Medicine Physician
  • Medford, OR
National Provider Identifier
1316214281
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD155331 Issued in OR
Practice address
2828 E Barnett Rd
Medford, OR 97504-8342
Phone
(541) 789-8000
Fax
(541) 789-8225
NPI assigned
Nov 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD155331 OR Primary

Addresses

Primary practice location

2828 E Barnett Rd
Medford, OR 97504-8342

Mailing address

2825 E Barnett Rd
MSS
Medford, OR 97504-8332
Phone (541) 789-4281

Other identifiers 3

IdentifierTypeStateIssuer
067665OtherOROMAP
227698MedicaidOR
500642273MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111228000412 OR Practitioner - Family PracticePractitioner - Emergency Medicine 9234305012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Arizona College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

555 Black Oak Dr
Medford, OR 97504-8491

625 SW Ramsey Ave
Suite a
Grants Pass, OR 97527-5808
Phone (541) 507-2290

Hospital & facility affiliations

  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Asante Physician Partners Family Medicine CurrentSince Nov 8, 2021 Accepting new patients
Ashland Emergency Associates, P.C. Past Accepting new patients

Locations

280 Maple St
Ashland, OR 97520
Phone (541) 201-4000

625 SW Ramsey Ave
Ste A
Grants Pass, OR 97527
Phone (541) 474-5004

555 Black Oak Dr
Ste 100
Medford, OR 97504
Phone (541) 774-5894

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

2828 E Barnett Rd
Medford, OR 97504
Phone (541) 774-5853

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 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": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1316214281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD",
            "address_2": "MSS",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-4281",
            "fax_number": "541-789-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048342",
            "telephone_number": "541-789-8000",
            "fax_number": "541-789-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIESSER",
        "first_name": "CARL",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-21",
        "last_updated": "2023-12-19",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD155331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "067665",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227698",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500642273",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.