Individual provider Active NPI

Steve E. Gruer, PA-C

  • Medical Physician Assistant
  • Murrieta, CA
National Provider Identifier
1760526263
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA17102 Issued in CA
Practice address
24671 Monroe Ave
# 102
Murrieta, CA 92562-2527
Phone
(951) 461-8143
Fax
(951) 461-8547
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA17102 CA Primary

Addresses

Primary practice location

24671 Monroe Ave
# 102
Murrieta, CA 92562-2527

Mailing address

24671 Monroe Ave
# 102
Murrieta, CA 92562-2527
Phone (951) 461-8143

Other identifiers 3

IdentifierTypeStateIssuer
PA17102OtherCALICENSE NUMBER
1760526263OtherCANPI
17704514945OtherCANPI - GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20080401000823 CA Practitioner - Physician Assistant 3476630419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Shams Iqbal IncGroup PAC ID 0143263418, 2 clinicians

Practice addresses (Care Compare)

3600 Lime St
Riverside, CA 92501-0944
Phone (951) 367-1060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA17102CAMDMedical Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1760526263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24671 MONROE AVE",
            "address_2": "# 102",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925622527",
            "telephone_number": "951-461-8143",
            "fax_number": "951-461-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24671 MONROE AVE",
            "address_2": "# 102",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925622527",
            "telephone_number": "951-461-8143",
            "fax_number": "951-461-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUER",
        "first_name": "STEVE",
        "middle_name": "E.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PA17102",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760526263",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - GROUP",
            "identifier": "17704514945",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.