Individual provider Active NPI

Derrick Grohe

  • Acute Care Nurse Practitioner
  • Sandusky, OH
National Provider Identifier
1811763584
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.0035870 Issued in OH
Practice address
1118 4TH St
Sandusky, OH 44870-4005
Phone
(419) 366-0575
NPI assigned
Dec 4, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.0035870 OH Primary

Addresses

Primary practice location

1118 4TH St
Sandusky, OH 44870-4005

Mailing address

1118 4TH St
Sandusky, OH 44870-4005
Phone (419) 366-0575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240507001808 OH Practitioner - Nurse Practitioner 3577904663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Coast Professional Company, LLCGroup PAC ID 6305810201, 105 clinicians

Practice addresses (Care Compare)

703 Tyler St
Suite 151
Sandusky, OH 44870-3392
Phone (419) 627-0207

Hospital & facility affiliations

  • Firelands Regional Medical Center Hospital, Sandusky, OH, CCN 360025
  • Bellevue Hospital Hospital, Bellevue, OH, CCN 360107
  • Memorial Hospital Hospital, Fremont, OH, CCN 360156
  • Magruder Hospital Hospital, Port Clinton, OH, CCN 361314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals St. John Medical Center CurrentSince Apr 22, 2024 Accepting new patients
North Coast Professional Company, LLC CurrentSince Feb 1, 2025 Accepting new patients
North Coast Professional Company, LLC Registered Nurse CurrentSince Feb 1, 2025 Accepting new patients

Locations

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

703 Tyler St
Ste 151
Sandusky, OH 44870
Phone (419) 627-0207

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

Interoperability endpoints

  • Direct secure messaging: dgrohe560526@ehrdirect.uhhospitals.org

Organizations & group practices 3

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 8

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": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1811763584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 4TH ST",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704005",
            "telephone_number": "419-366-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 4TH ST",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704005",
            "telephone_number": "419-366-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROHE",
        "first_name": "DERRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-04",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.0035870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.