Individual provider Active NPI

Jennifer Gruber, NP

  • Nurse Practitioner
  • Terre Haute, IN
National Provider Identifier
1992150965
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71006223A Issued in IN
Practice address
1429 N 6TH St
Terre Haute, IN 47807-1019
Phone
(812) 232-0564
NPI assigned
Apr 27, 2016
Last updated
Apr 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71006223A IN Primary

Addresses

Primary practice location

1429 N 6TH St
Terre Haute, IN 47807-1019

Mailing address

221 S 6TH St
Terre Haute, IN 47807-4214
Phone (812) 232-0564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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

Enrollment IDStateProvider typePAC IDDetails
I20190603003112 HI Practitioner - Nurse Practitioner 4880983873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1380 Lusitana St
Honolulu, HI 96813-2448

91 -2127 Fort Weaver Rd
Ewa Beach, HI 96706-1993
Phone (808) 691-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71006223AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince May 1, 2019 Accepting new patients
The Queen's Medical Center CurrentSince May 1, 2019 Accepting new patients
Queens University Medical Group CurrentSince Apr 22, 2022 Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

1380 Lusitana St
Ste 608
Honolulu, HI 96813
Phone (808) 532-0315

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

550 S Beretania St
Ste 202
Honolulu, HI 96813
Phone (808) 585-2900

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

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 1

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1992150965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S 6TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478074214",
            "telephone_number": "812-232-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 N 6TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478071019",
            "telephone_number": "812-232-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006223A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.