Michael Emanuel Grillis, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

34004664 Issued in OH

Practice address

2281 Hayes Ave
Fremont, OH 43420-2632

Phone

(419) 355-8488

Fax

(419) 355-8890

NPI assigned

Aug 29, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

General Surgery

Education

West Virginia School of Osteopathic Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Professional Services LTDGroup PAC ID 1456531870, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Hospital, Fremont, OH, CCN 360156
• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
• Bellevue Hospital Hospital, Bellevue, OH, CCN 360107

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgrillis24671@direct.promedica.org

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Memorial Hospital

  • General Acute Care Hospital
  • Fremont, OH
  • NPI 1851338149

  Corporate Director

  CMS ownership

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.

• Memorial Professional Services LTD

  • Pulmonary Disease Physician
  • Fremont, OH
  • NPI 1205139623
  Medicare reassignment Care Compare group NPD

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

• Memorial Hospital

  • General Acute Care Hospital
  • Fremont, OH
  • NPI 1851338149
  Care Compare affiliation
• The Bellevue Hospital

  • General Acute Care Hospital
  • Bellevue, OH
  • NPI 1134161623
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1508974494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 COUNTY ROAD 398",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434209253",
            "telephone_number": "419-334-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2281 HAYES AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202632",
            "telephone_number": "419-355-8488",
            "fax_number": "419-355-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLIS",
        "first_name": "MICHAEL",
        "middle_name": "EMANUEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34004664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0739964",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michaelle Ann Goodman
• Great Lakes Community Action Partnership
• Great Lakes Recovery Center LLC
• Courtney Renee Greenwood, DMD
• Danielle Nicole Grieb, APRN-CNP
• Grund Drug Co
• David Guardiola, MSW, LISW
• Louis Pablo Guardiola, MSCJ, CDCA
• Ashley Guerra
• Benito Guerrero-Vasquez, QMHS

• Surgery Physician in Fremont, OH
• Providers in Fremont, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.