Individual provider Active NPI

Jared M Grinney, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1902209711
Registry record updated Jan 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5851 Issued in AZ
Practice address
1124 E McKellips Rd Ste 100
Mesa, AZ 85203-2765
Phone
(623) 683-8000
NPI assigned
Oct 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5851 AZ Primary

Addresses

Primary practice location

1124 E McKellips Rd Ste 100
Mesa, AZ 85203-2765

Mailing address

1124 E McKellips Rd Ste 100
Mesa, AZ 85203-2765
Phone (623) 683-8000

Other identifiers 1

IdentifierTypeStateIssuer
978601MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150107000900 AZ Practitioner - Physician Assistant 1254654833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

10510 N 92ND St
Scottsdale, AZ 85258-4566

2121 W Chandler Blvd
Suite 110
Chandler, AZ 85224-6576
Phone (480) 963-2233

7400 E Thompson Peak Pkwy
Scottsdale, AZ 85255-4109
Phone (480) 324-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5851AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scottsdale Healthcare Corp CurrentSince Dec 1, 2024 Accepting new patients
Honorhealth Ambulatory CurrentSince Dec 1, 2024 Accepting new patients
Honorhealth Ambulatory Current Accepting new patients
Honorhealth Ambulatory CurrentSince Dec 1, 2024 Accepting new patients
Honorhealth Ambulatory Surgical Past Accepting new patients

Locations

1124 E McKellips Rd
Ste 102
Mesa, AZ 85203
Phone (480) 587-5520

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

Interoperability endpoints

  • Direct secure messaging: jgrinney50348@direct.honorhealth.com

Organizations & group practices 5

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 1

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": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735948800000",
    "number": "1902209711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 E MCKELLIPS RD STE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032765",
            "telephone_number": "623-683-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 E MCKELLIPS RD STE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032765",
            "telephone_number": "623-683-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINNEY",
        "first_name": "JARED",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-07",
        "last_updated": "2025-01-04",
        "certification_date": "2025-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "978601",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.