Individual provider Active NPI

Anthony Michael Grilliot, CRNA

  • Certified Registered Nurse Anesthetist
  • Lima, OH
National Provider Identifier
1659898211
Registry record updated Mar 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.019559 Issued in OH
Practice address
1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone
(419) 228-3335
NPI assigned
Aug 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.345017 OH
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.019559 OH Primary

Addresses

Primary practice location

1001 Bellefontaine Ave
Lima, OH 45804-2800

Mailing address

1825 Barnhart Rd
Troy, OH 45373-9589
Phone (937) 552-9420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171117001210 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951667393 Reassigns benefits to 2 organizations
I20190306003638 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951667393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PHS Anesthesia Billing, LLCGroup PAC ID 2264958412, 241 clinicians
Surgery One Anesthesia LLCGroup PAC ID 8820351463, 32 clinicians
Cable Sleep LLCGroup PAC ID 2567892268, 6 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8000

5050 N Clinton St
Fort Wayne, IN 46825-5886
Phone (260) 484-8551

512 N Cable Rd
Lima, OH 45805-2133
Phone (419) 228-2600

Hospital & facility affiliations

  • Orthopaedic Hospital at Parkview North Hospital, Fort Wayne, IN, CCN 150167
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.345017OHMDRegistered Nurse
APRN.CRNA.019559OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cable Sleep LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 19, 2022 Accepting new patients
Surgery One Anesthesia, LLC CurrentSince Mar 4, 2019 Accepting new patients
PHS Anesthesia Billing, LLC CurrentSince Jan 3, 2026 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

5050 N Clinton St
Fort Wayne, IN 46825
Phone (219) 484-8551

5052 N Clinton St
Fort Wayne, IN 46825
Phone (260) 408-2203

11130 Parkview Circle Dr
Fort Wayne, IN 46845
Phone (260) 266-6221

11420 Parkview Circle Dr
Fort Wayne, IN 46845
Phone (260) 482-5194

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520208000000",
    "number": "1659898211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 BARNHART RD",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453739589",
            "telephone_number": "937-552-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BELLEFONTAINE AVE",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042800",
            "telephone_number": "419-228-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLIOT",
        "first_name": "ANTHONY",
        "middle_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-24",
        "last_updated": "2018-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.345017",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.019559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.