Active NPI
Cassandra Mary Gruber, PA-C
- Physician Assistant
- Madras, OR
National Provider Identifier
1821718693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA222387
- Practice address
- 76 NE 12TH St
Madras, OR 97741-1827 - Phone
- (541) 475-3874
- NPI assigned
- Aug 31, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA222387 | OR | Primary |
Addresses
Primary practice location
76 NE 12TH St
Madras, OR 97741-1827
Mailing address
346 SE Carmen Way
Madras, OR 97741-2211
Phone (425) 770-5678
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241204004159 | OR | Practitioner - Physician Assistant | 1052846318 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Madras Medical Group PC
Practice addresses (Care Compare)
76 NE 12TH St
Madras, OR 97741-1827
Phone (541) 475-3874
Hospital & facility affiliations
- St Charles Madras
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- cassandra.gruber.1@14009.direct.athenahealth.com
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.
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": "1661904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1821718693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "346 SE CARMEN WAY",
"city": "MADRAS",
"state": "OR",
"postal_code": "977412211",
"telephone_number": "425-770-5678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "76 NE 12TH ST",
"city": "MADRAS",
"state": "OR",
"postal_code": "977411827",
"telephone_number": "541-475-3874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUBER",
"first_name": "CASSANDRA",
"middle_name": "MARY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-31",
"last_updated": "2024-10-25",
"certification_date": "2024-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA222387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madras, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.