Shelbi K Grothaus, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10003693A Issued in IN

Practice address

705 Riley Hospital Dr
Indianapolis, IN 46202-5109

Phone

(317) 274-4779

Fax

(317) 948-9806

NPI assigned

Jun 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgrothaus342101@direct.seattlechildrens.org

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.

• Providence Health & Services-Wa

  • Mammography Clinic/Center
  • Everett, WA
  • NPI 1336390442
  Medicare reassignment
• Seattle Children'S Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  Medicare reassignment
• Providence Health & Services-Wa

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Everett, WA
  • NPI 1033360144
  NPD
• Providence Health & Services-Washington

  • Ambulatory Surgical Clinic/Center
  • Everett, WA
  • NPI 1588294854
  NPD
• Seattle Childrens Hospital

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD
• University Pediatric Associates, Inc.

  • Pediatrics Physician
  • Indianapolis, IN
  • NPI 1457396541

  Physician Assistant

  NPD (past)
• Seattle Children'S Hospital

  • Home Infusion Agency
  • Bothell, WA
  • NPI 1245383348
  NPD (past)

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1912639162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1026",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061026",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-274-4779",
            "fax_number": "317-948-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTHAUS",
        "first_name": "SHELBI",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003693A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300066158",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John C Grotberg, MD
• Rebecca Grote, PA-C
• Stephen Michael Grote, MD, PHD
• Cheryl Kristine Groth, PMHNP
• Theresa Groth
• Sarah Grothouse
• Grounded & Blooming Therapy, LLC
• Groundwork Case Management Solutions Inc
• Randall Grout, M.D., M.S.
• Dara Danelle Grove, OT

• Physician Assistant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.