Jordania Grullon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA064032 Issued in PA

Practice address

175 S Wilkes Barre Blvd
Wilkes Barre, PA 18702-5040

Phone

(570) 208-6281

Fax

(570) 208-6282

NPI assigned

Oct 4, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Gastroenterology Center, Inc.Group PAC ID 2264410224, 7 clinicians

Greater Hazleton Gastroenterology PCGroup PAC ID 4082038625, 4 clinicians

Caring Community Health CenterGroup PAC ID 5698004588, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lehigh Valley Hospital - Hazleton Hospital, Hazleton, PA, CCN 390185

Merit-based Incentive Payment System (MIPS)

Final score

85.41 of 100Reported as group

Quality

70.82

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

91.32 of 100Reported as group

Quality

81.14

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgrullon559563@direct.geisinger.edu

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.

• Northeast Gastroenterology Center, Inc.

  • Gastroenterology Physician
  • Hazle Township, PA
  • NPI 1164509287
  Medicare reassignment Care Compare group NPD (past)
• Caring Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Wilkes Barre, PA
  • NPI 1679038293
  Medicare reassignment Care Compare group
• Greater Hazleton Gastroenterology, P.C.

  • Gastroenterology Physician
  • Hazle Township, PA
  • NPI 1427683580
  Medicare reassignment Care Compare group
• Caring Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Scranton, PA
  • NPI 1891547964
  NPD

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

• Lehigh Valley Hospital Hazleton

  • General Acute Care Hospital
  • Hazleton, PA
  • NPI 1548322720
  Care Compare affiliation

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1679298400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-208-6281",
            "fax_number": "570-208-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S WILKES BARRE BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187025040",
            "telephone_number": "570-208-6281",
            "fax_number": "570-208-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRULLON",
        "first_name": "JORDANIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dara Lynne Grevera, RPH BCMTMS
• Christoph Johannes Griessenauer, M.D.
• Brittany Ann Griffith, LSW
• Lawrence Joel Grill, M.D.
• Mitchell J. Gross, M.D.
• Emily E Grum, MD
• Brenda Lee Grunza, BSN, RN
• John N Grutkowski, PH.D.
• Stephen Gruver, PHARMD
• Tatiana Fiorella Guerrero-David

• Physician Assistant in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.