Individual provider Active NPI

Jason M Grosdidier, MD

  • Family Medicine Physician
  • East Wenatchee, WA
National Provider Identifier
1972534832
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00043600 Issued in WA
Practice address
100 Highline Dr
East Wenatchee, WA 98802-5341
Phone
(509) 884-0614
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00043600 WA Primary

Addresses

Primary practice location

100 Highline Dr
East Wenatchee, WA 98802-5341

Mailing address

820 N Chelan Ave
Wenatchee, WA 98801-2028

Other identifiers 3

IdentifierTypeStateIssuer
P01290278OtherWARR MEDICARE
0184960OtherWAL&I
1972534832MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address JGROSDIDIER2359@EDIRECT.CHEHR.ORG
FHIR URL https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040607000912 WA Practitioner - Family Practice 0547242067 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 S Miller St
Wenatchee, WA 98801-3201
Phone (509) 662-2208

Hospital & facility affiliations

  • Central Washington Health Services Home health agency, Wenatchee, WA, CCN 507029
  • Assured Home Health Home health agency, Moses Lake, WA, CCN 507048
  • Advanced Home Health NW of Wenatchee Home health agency, Wenatchee, WA, CCN 507113
  • Confluence Health Hospital Hospital, Wenatchee, WA, CCN 500016

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wenatchee Valley Hospital Current Accepting new patients
Central Washington Health Services Association CurrentSince Jun 1, 2022 Accepting new patients
Wenatchee Valley Hospital CurrentSince Jul 21, 2013 Accepting new patients
Central Washington Health Services Association Current Accepting new patients
Ozark Tri-County Health Care Consortium Past Accepting new patients

Locations

840 E Hill Ave
Moses Lake, WA 98837
Phone (509) 764-6400

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

100 Highline Dr
Wenatchee, WA 98802
Phone (509) 884-0614

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

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 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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1972534832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLINE DR",
            "city": "EAST WENATCHEE",
            "state": "WA",
            "postal_code": "988025341",
            "telephone_number": "509-884-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSDIDIER",
        "first_name": "JASON",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00043600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01290278",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0184960",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972534832",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JGROSDIDIER2359@EDIRECT.CHEHR.ORG",
            "affiliation": "N",
            "address_1": "100 Highline Dr",
            "city": "East Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988025341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "100 Highline Dr",
            "city": "East Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988025341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.