Jacob Pauly Gribb

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

DS042834 Issued in PA

Practice address

500 Heritage Dr
Pottstown, PA 19464-3233

Phone

(610) 326-7880

Fax

(610) 323-1520

NPI assigned

Mar 23, 2020

Sex

Male

Sole proprietor

Yes

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 PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pottstown Oral and Maxillofacial Surgery Assoc. IncGroup PAC ID 2668442492, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pottstown Hospital Hospital, Pottstown, PA, CCN 390123

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pottstown Oral & Maxillofacial Surgery Assoc. Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Pottstown, PA
  • NPI 1285638817
  Medicare reassignment Care Compare group NPD
• Gribb Omfs LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Wilmington, DE
  • NPI 1508677493
  NPD Authorized official

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

• Pottstown Hospital, LLC

  • Hematology & Oncology Physician
  • Pottstown, PA
  • NPI 1093225369

  Hospital

  Care Compare affiliation
• Pottstown Hospital, LLC

  • General Acute Care Hospital
  • Pottstown, PA
  • NPI 1649794421
  Care Compare affiliation

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1316574288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W 14TH ST STE 2W22",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HERITAGE DR",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643233",
            "telephone_number": "610-326-7880",
            "fax_number": "610-323-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIBB",
        "first_name": "JACOB",
        "middle_name": "PAULY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "DS042834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Alan Greenberg, PH.D.
• Micah Raine Greene
• Mykel Greene, MS
• Claudia Greenholt
• Niya S Grenevich, MS
• Lawrence J Gribb, DMD
• Donna Griffin
• Gina Yvette Griffin
• Erin Theresa Groff
• Michelle Elizabeth Groff, CPS

• Oral & Maxillofacial Surgery (D.M.D.) in Pottstown, PA
• Providers in Pottstown, PA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.

Verify at the official NPI Registry.