NPIMap

Individual provider Active NPI

Kimberly Grillo McLean, D.O.

  • Orthopaedic Surgery Physician
  • Pontiac, MI
National Provider Identifier
1942513353
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
01923 Issued in MI
Practice address
50 N Perry St
Pontiac, MI 48342-2217
Phone
(248) 338-5392
NPI assigned
Jul 15, 2010
Last updated
Sep 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 01923 MI Primary

Addresses

Primary practice location

50 N Perry St
Pontiac, MI 48342-2217

Mailing address

4125 Binghampton CT
Clarkston, MI 48348-5078

Other names 1

  • Kimberly Lynn Grillo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160817001968 MI Practitioner - Orthopedic Surgery 0840434080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ella E M Brown Charitable CircleGroup PAC ID 1254228745, 172 clinicians

Practice addresses (Care Compare)

200 N Madison St
Marshall, MI 49068-1143
Phone (269) 781-4271

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.06 of 100Reported as group
Quality
85.32
Promoting interoperability
100
Improvement activities
40
Cost
71.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement41
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
01923MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle CurrentSince Aug 29, 2016 Accepting new patients
Ella E M Brown Charitable Circle CurrentSince Aug 29, 2016 Accepting new patients
Ella E M Brown Charitable Circle Past Accepting new patients

Locations

302 N Monroe St
Ste A
Albion, MI 49224
Phone (517) 629-2134

5352 Beckley Rd
Ste A
Battle Creek, MI 49015
Phone (269) 979-6800

1174 W Michigan Ave
Ste A
Marshall, MI 49068
Phone (269) 558-0700

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

203 Winston Dr
Marshall, MI 49068
Phone (269) 789-1670

Interoperability endpoints

  • Direct secure messaging: kimberly.mclean.1@9698.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1942513353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 BINGHAMPTON CT",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483485078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N PERRY ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422217",
            "telephone_number": "248-338-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "KIMBERLY",
        "middle_name": "GRILLO",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "01923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GRILLO",
            "middle_name": "LYNN",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.