Jonathan L Grosdidier, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

7331A Issued in WY

Practice address

111 S 5TH St
Douglas, WY 82633-2434

Phone

(307) 358-2122

Fax

(307) 358-9216

NPI assigned

Sep 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

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

Specialty

General Surgery

Education

Sanford School of Medicine of University of South Dakota, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Hospital of Converse CountyGroup PAC ID 2264340843, shared by 5 NPIs, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital of Converse County Hospital, Douglas, WY, CCN 531302

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgrosdidier@direct.mhccwyo.org

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.

• Memorial Hospital of Converse County

  • Critical Access Hospital
  • Douglas, WY
  • NPI 1326085408
  Medicare reassignment NPD
• Memorial Hospital of Converse County

  • General Practice Physician
  • Douglas, WY
  • NPI 1356496491
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Hospital of Converse County

  • Critical Access Hospital
  • Douglas, WY
  • NPI 1326085408
  Care Compare affiliation

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992808398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 5TH ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332434",
            "telephone_number": "307-358-2122",
            "fax_number": "307-358-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 5TH ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332434",
            "telephone_number": "307-358-2122",
            "fax_number": "307-358-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSDIDIER",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WY",
            "license": "7331A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF WYOMING",
            "identifier": "314089",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christy L Garcia
• Melodie Good
• Sherry Kay Goodrich
• Samantha Marie Grinstead
• Ashley M Groh
• Mary Gubbels
• Herbert Ray Haley
• Jillian K Haley
• Hand and Physical Therapy of Wyoming Limited Partnership
• Hand Therapy of Wyoming Douglas/Casper

• Surgery Physician in Douglas, WY
• Providers in Douglas, WY by specialty
• Surgery Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.