Jack W Grinnan, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

55776 Issued in AZ

Practice address

2530 E Southern Ave
Mesa, AZ 85204-5411

Phone

(480) 834-4188

Fax

(480) 834-6181

NPI assigned

May 20, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, MD2 enrollments

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 2

Specialty

Urology

Education

University of Texas Medical School at San Antonio, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Arizona Urology Specialists PLLCGroup PAC ID 5092863852, 84 clinicians

Chesapeake Urology Associates LLCGroup PAC ID 4789673393, 161 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088
• Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
• Saint Agnes Hospital Hospital, Baltimore, MD, CCN 210011
• Banner Payson Medical Center Hospital, Payson, AZ, CCN 031318

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jackgrinnan@fu.allscriptsdirect.net
• FHIR API: https://app.meldrx.com/api/fhir/uc11142_phoenixurology

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.

• Arizona Urology Specialists, PLLC

  • Urology Physician
  • Phoenix, AZ
  • NPI 1740426485
  Medicare reassignment Care Compare group NPD
• Chesapeake Urology Associates, LLC

  • Hematology & Oncology Physician
  • Stevensville, MD
  • NPI 1467337337
  Medicare reassignment Care Compare group
• Chesapeake Urology Associates LLC

  • Urology Physician
  • Owings Mills, MD
  • NPI 1609823004
  NPD
• Chesapeake Urology Associates, LLC

  • Urology Physician
  • Pikesville, MD
  • NPI 1124843990
  NPD
• Foothills Urology, PC

  • Urology Physician
  • Golden, CO
  • NPI 1780617795
  NPD
• Phoenix Urological Surgeons PC

  • Urology Physician
  • Phoenix, AZ
  • NPI 1811908544
  NPD (past)

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

• Banner Baywood Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1194758284
  Care Compare affiliation
• Banner Gateway Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1699884858
  Care Compare affiliation
• Banner Health

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340
  Care Compare affiliation
• St. Agnes Healthcare, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1245274901
  Care Compare affiliation

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1487090288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 GRAND CENTRAL AVE STE 220",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045411",
            "telephone_number": "480-834-4188",
            "fax_number": "480-834-6181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321956",
            "country_code": "US",
            "telephone_number": "860-679-2147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRINNAN",
        "first_name": "JACK",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-20",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "55776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372496",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ernestina Grijalva
• Blanca Monica Grimaldo
• Francis Grimes, CCC-SLP
• Cathy L Grimsley
• Donald Lynn Griner, D.O.
• Jared M Grinney, PA-C
• Deborah R. Grischo, FNPC
• Linda Carol Grissom, N.P.
• Denise Q Grobe, N.D.
• Heidi Gabrielle Grodman

• Urology Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Urology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.