Jacob H Gregerson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35.138535 Issued in OH

Practice address

5175 Morse Rd Ste 400
Gahanna, OH 43230-3458

Phone

(614) 741-4411

Fax

(614) 741-4412

NPI assigned

Jul 9, 2012

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: jacob.gregerson.1@16923.direct.athenahealth.com
• Direct secure messaging: jgregerson19089@copcp.medicity.net
• Direct secure messaging: jacob.gregerson.p1@direct.mhhc.nextgenshare.com

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.

• Central Ohio Primary Care Physicians Inc

  • Hospitalist Physician
  • Westerville, OH
  • NPI 1518398866
  NPD
• Central Ohio Primary Care Physicians, Inc.

  • Internal Medicine Physician
  • Westerville, OH
  • NPI 1194705194

  Pediatrics

  NPD (past)
• Central Ohio Primary Care Physicians, Inc.

  • Clinical Medical Laboratory
  • Westerville, OH
  • NPI 1639279045
  NPD (past)
• PM Pediatrics of Bayside PLLC

  • Urgent Care Clinic/Center
  • Nanuet, NY
  • NPI 1861823197
  NPD (past)
• PM Pediatrics of Mamaroneck

  • Urgent Care Clinic/Center
  • Mamaroneck, NY
  • NPI 1073645180
  NPD (past)
• PM Pediatrics PC

  • Urgent Care Clinic/Center
  • Syosset, NY
  • NPI 1730212390

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1417212291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5175 MORSE RD STE 400",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432303458",
            "telephone_number": "614-741-4411",
            "fax_number": "614-741-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5175 MORSE RD STE 400",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432303458",
            "telephone_number": "614-741-4411",
            "fax_number": "614-741-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGERSON",
        "first_name": "JACOB",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.138535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Graham
• Shawna N Grayson, LMT
• Ashley Michelle Green, NP
• Jacquata Green
• Leslie M Green, M.D.
• Sarah Elizabeth Grim, LISW-S
• Austin Michael Grist, DO
• Ellen S Grudowski, LISW-S
• Marissa Kathleen Gruenbaum, PA-C
• William Christopher Guinther, RPH

• Pediatrics Physician in Gahanna, OH
• Providers in Gahanna, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.