NPIMap

Individual provider Active NPI

John Vanloon Grimes, PA-C

  • Physician Assistant
  • Scranton, PA
National Provider Identifier
1740659762
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA057958 Issued in PA
Practice address
1800 Mulberry St
M. C. 68-74
Scranton, PA 18510-6800
Phone
(570) 703-7245
Fax
(570) 703-7325
NPI assigned
Sep 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA057958 PA
Surgical Physician Assistant 363AS0400X OA003665 PA
Physician Assistant 363A00000X MA057958 PA Primary

Addresses

Primary practice location

1800 Mulberry St
M. C. 68-74
Scranton, PA 18510-6800

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
466481OtherPAMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgrimes129497@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160112002990 PA Practitioner - Physician Assistant 8921300609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 826-7300

1800 Mulberry St
Scranton, PA 18510-2369
Phone (570) 969-7355

3 W Olive St
Scranton, PA 18508-2572
Phone (570) 207-5970

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA057958PAMDPhysician Assistant
OA003665PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jan 4, 2016 Accepting new patients
Geisinger Clinic Physician Assistant CurrentSince Jan 4, 2016 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

439 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-1444

100 N Academy Ave
Danville, PA 17822

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

1800 Mulberry St
#M
Scranton, PA 18510
Phone (570) 703-7245

Interoperability endpoints

  • Direct secure messaging: jgrimes129497@direct.geisinger.edu

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 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1740659762",
    "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": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MULBERRY ST",
            "address_2": "M. C. 68-74",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185106800",
            "telephone_number": "570-703-7245",
            "fax_number": "570-703-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "JOHN",
        "middle_name": "VANLOON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-21",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA057958",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "OA003665",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "466481",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgrimes129497@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1800 Mulberry St",
            "address_2": "M. C. 68-74",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185106800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.