Jennifer Grugan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C5-0011604 Issued in DE

Practice address

4745 Ogletown Stanton Rd Ste 217
Newark, DE 19713-2074

Phone

(302) 733-2410

NPI assigned

Feb 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1972196012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR STE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD STE 217",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132074",
            "telephone_number": "302-733-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUGAN",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brielle Joella Grote
• Arianna Grott, MSN, FNP-C
• Breanne Callan Grove, PA-C
• David Schuler Grubbs, M.D.
• Stephen S Grubbs, MD
• Ruth S Grulich, LCSW
• Jae Marie Grymes, DDS
• Guardian Angel Home Health Care Agency, LLC
• Melissa Hoffman Guarino, PA-C
• Julie B Guarneri, P.T.

• Physician Assistant in Newark, DE
• Providers in Newark, DE by specialty
• Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.