NPIMap

Individual provider Active NPI

Joshua Cole Gratwohl, PA-C

  • Physician Assistant
  • Salem, OR
National Provider Identifier
1386370898
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA212866 Issued in OR
Practice address
925 Commercial St SE Ste 320
Salem, OR 97302-4173
Phone
(971) 259-1508
NPI assigned
Jul 27, 2022
Last updated
Jul 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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 PA212866 OR Primary

Addresses

Primary practice location

925 Commercial St SE Ste 320
Salem, OR 97302-4173

Mailing address

925 Commercial St SE Ste 320
Salem, OR 97302-4173
Phone (971) 259-1508

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919002647 OR Practitioner - Physician Assistant 5496130924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Salem Clinic PCGroup PAC ID 7517954514, 96 clinicians

Practice addresses (Care Compare)

2020 Capitol St NE
Salem, OR 97301-0644
Phone (503) 399-2424

5900 Inland Shores Way N
Suite 100
Keizer, OR 97303-3883
Phone (503) 399-2424

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA212866ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Clinic, PC CurrentSince Jul 15, 2024 Accepting new patients

Locations

5900 Inland Shores Way N
Keizer, OR 97303
Phone (503) 399-2470

5900 Inland Shores Way N
Ste 100
Keizer, OR 97303

2020 Capitol St NE
Salem, OR 97301
Phone (503) 399-2470

Interoperability endpoints

  • Direct secure messaging: jgratwohl38936@salemclinic.gardenplot.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 12

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": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1386370898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 COMMERCIAL ST SE STE 320",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024173",
            "telephone_number": "971-259-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 COMMERCIAL ST SE STE 320",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024173",
            "telephone_number": "971-259-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRATWOHL",
        "first_name": "JOSHUA",
        "middle_name": "COLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA212866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.