Individual provider Active NPI

Trevor Grubbs, M.D., M.S.P.H

  • Emergency Medicine Physician
  • Meridian, ID
National Provider Identifier
1477748507
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M-13051 Issued in ID
Practice address
3080 E Gentry Way Ste 210
Meridian, ID 83642-3013
Phone
(208) 384-9022
NPI assigned
Sep 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X M-13051 ID Primary

Addresses

Primary practice location

3080 E Gentry Way Ste 210
Meridian, ID 83642-3013

Mailing address

3080 E Gentry Way Ste 210
Meridian, ID 83642-3013
Phone (208) 384-9022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20151217001913 ID Practitioner - Emergency Medicine 8527120237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-13051IDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Emergency Medicine CurrentSince Dec 1, 2015 Accepting new patients
Baptist Health Medical Group, Inc. Emergency Medicine Past Accepting new patients

Locations

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

1202 E Locust St
Emmett, ID 83617
Phone (208) 365-2338

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

Interoperability endpoints

  • Direct secure messaging: tgrubbs31024@direct.slhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1477748507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 E GENTRY WAY STE 210",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423013",
            "telephone_number": "208-384-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 E GENTRY WAY STE 210",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423013",
            "telephone_number": "208-384-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBBS",
        "first_name": "TREVOR",
        "credential": "M.D., M.S.P.H",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-13051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.