Individual provider Active NPI

Melissa J Grigsby, MD

  • Trauma Surgery Physician
  • Newark, NJ
National Provider Identifier
1588014971
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
25MA11944900 Issued in NJ
Practice address
150 Bergen St
Newark, NJ 07103-2496
Phone
(973) 972-0376
NPI assigned
Jun 16, 2016
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01095238A IN
Surgical Critical Care Physician 2086S0102X 01095238A IN
Trauma Surgery Physician 2086S0127X 25MA11944900 NJ Primary

Addresses

Primary practice location

150 Bergen St
Newark, NJ 07103-2496

Mailing address

150 Bergen St # M229
Newark, NJ 07103-2496

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 962-2000

Other identifiers 2

IdentifierTypeStateIssuer
300099580MedicaidIN
1102139741OtherINANTHEM PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgrigsby@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, IN2 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

Enrollment IDStateProvider typePAC IDDetails
I20230929001031 NJ Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 6901250620 Reassigns benefits to 1 organization
I20241118000968 IN Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 6901250620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Bergen St
Newark, NJ 07107-3000
Phone (973) 972-0037

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01095238AINMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Surgeons, Inc. Surgery CurrentSince Dec 4, 2024 Accepting new patients
University Physician Associates of New Jersey Inc Surgery CurrentSince Oct 1, 2023 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Oct 1, 2023 Accepting new patients
Indiana University Health West Hospital Inc Past Accepting new patients
Indiana University Health Inc Past Accepting new patients
Indiana University Health Inc Past Accepting new patients
University Hospital Past Accepting new patients
Regents of the Univ of Ca Surgery Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
The Health and Hospital Corporation of Marion County Past Accepting new patients
Indiana University Health North Hospital Inc Past Accepting new patients
Indiana University Health Inc Past Accepting new patients

Locations

7630 Solutions Ctr
Chicago, IL 60677

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

150 Bergen St
#M229
Newark, NJ 07103

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

30 Bergen St
Bldg 12
Newark, NJ 07107
Phone (973) 972-0037

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1588014971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST # M229",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-0376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "317-962-2000",
            "fax_number": "317-968-1127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIGSBY",
        "first_name": "MELISSA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01095238A",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IN",
            "license": "01095238A",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NJ",
            "license": "25MA11944900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300099580",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "1102139741",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgrigsby@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.