Nicole Marie Grunthaner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA055234 Issued in PA

Practice address

123 Hospital Avenue
Du Bois, PA 15801-1409

Phone

(814) 371-1510

Fax

(814) 371-2922

NPI assigned

Oct 12, 2011

Last updated

Dec 13, 2022By the provider in NPPES

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 names 1

• Nicole Marie Whalen Former name

Medicare fee-for-service enrollment

Enrolled in PA

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: nmgrunthaner@1285.direct.myezyaccess.com

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.

• Dubois Regional Medical Center

  • Family Medicine Physician
  • Du Bois, PA
  • NPI 1245410554

  Physician Assistant

  Medicare reassignment NPD
• Dubois Regional Medical Center

  • Pediatrics Physician
  • Du Bois, PA
  • NPI 1801094222

  Physician Assistant

  Medicare reassignment NPD
• Dubois Regional Medical Group, PC

  • Multi-Specialty Clinic/Center
  • Du Bois, PA
  • NPI 1285728915

  Physician Assistant

  Medicare reassignment NPD
• Dubois Regional Medical Center

  dba Penn Highlands DuBois

  • Pharmacy
  • Ridgway, PA
  • NPI 1366900458
  NPD
• Dubois Regional Medical Group, PC

  • Family Medicine Physician
  • Du Bois, PA
  • NPI 1093956617

  Physician Assistant

  NPD
• Dubois Regional Medical Center

  dba Penn Highlands DuBois

  • General Acute Care Hospital
  • Du Bois, PA
  • NPI 1144249657

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1952686784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-371-2200",
            "fax_number": "814-371-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL AVENUE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011409",
            "telephone_number": "814-371-1510",
            "fax_number": "814-371-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNTHANER",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "WHALEN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather K Griffith, CRNP
• Taylor Lynn Grimm, CRNP
• Carlie Rae Gritzer, M.S. CCC-SLP
• Growing Joy Imaging, LLC
• David Thomas Gruda, DC
• Jessica Gruver, OD
• Prasad D Gupta, MD
• Elisabeth Kylee Gural
• Brandi Nicole Gwin, M.S.W.
• Lauren Haag, MA

• Physician Assistant in Du Bois, PA
• Providers in Du Bois, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.