Jacob Stuart Grange, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MD186209 Issued in OR

Practice address

1032 E Jackson St
Medford, OR 97504

Phone

(541) 770-4559

Fax

(541) 770-4511

NPI assigned

Apr 17, 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

Medicare fee-for-service enrollment

Enrolled in OR, CA, UT3 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 3

Specialty

Pathology

Education

University of Texas Southwestern Medical School at Dallas, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vista Pathology Laboratory LLCGroup PAC ID 4587827985, 12 clinicians

Siskiyou Hospital IncGroup PAC ID 1254223134, 96 clinicians

Associates of Pathology PCGroup PAC ID 0840194072, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
• Providence Medford Medical Center Hospital, Medford, OR, CCN 380075
• Curry General Hospital Hospital, Gold Beach, OR, CCN 381322
• Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Vista Pathology Laboratory, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Medford, OR
  • NPI 1487928420
  Medicare reassignment Care Compare group NPD
• Associates of Pathology, P.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Ogden, UT
  • NPI 1760679443
  Medicare reassignment Care Compare group NPD
• Siskiyou Hospital, Inc.

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1093892275
  Medicare reassignment Care Compare group NPD
• Vista Pathology Laboratory, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Gold Beach, OR
  • NPI 1649544685
  NPD

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

• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation
• Curry Health District

  • Critical Access Hospital Clinic/Center
  • Brookings, OR
  • NPI 1083656367
  Care Compare affiliation
• Curry Health District

  • Critical Access Hospital
  • Gold Beach, OR
  • NPI 1487696985
  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1689755670
  Care Compare affiliation
• Columbia Ogden Medical Center, Inc.

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1720031636
  Care Compare affiliation

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1508200833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047027",
            "telephone_number": "541-770-4559",
            "fax_number": "541-770-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-770-4559",
            "fax_number": "541-770-4511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_2": "Box 800904",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-982-1018",
            "fax_number": "434-924-9492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANGE",
        "first_name": "JACOB",
        "middle_name": "STUART",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-17",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116026086",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OR",
            "license": "MD186209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Graham
• John Michael Gram, PSY.D.
• Deanna Granacki
• Ashley Grandkoski, LMT, L.AC.
• Joshua Ryan Graner, L.AC
• Austin Marc Burns Grant, MD
• Collin Grant, M.D.
• David Michael Grant, MD
• Peter Alan Grant, MD
• Grape Street Massage LLC

• Anatomic Pathology & Clinical Pathology Physician in Medford, OR
• Providers in Medford, OR by specialty
• Anatomic Pathology & Clinical Pathology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.