Jeffrey L Grassle (NPI# 1205802147, PAC ID# 0840263372) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1205802147 |
| PAC ID by PECOS | 0840263372 |
| Professional Enrollment ID | I20040813000675 |
| Full Name | Jeffrey L Grassle |
| Organization Legal Name | GRANITE CITY EMERGENCY MEDICINE PROVIDERS LLC |
| Address |
2100 Madison Ave Granite City IL 62040-4713 |
| Phone Number | 6188331691 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF KANSAS SCHOOL OF MEDICINE |
| Graduation Year | 1985 |
| Primary Specialty | EMERGENCY MEDICINE |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 7012205784 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140130 | NORTHWESTERN LAKE FOREST HOSPITAL |
| 140125 | GATEWAY REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2100 Madison Ave, Granite City, IL 62040-4713 | 6188331691 | GRANITE CITY EMERGENCY MEDICINE PROVIDERS LLC |
| Organization Legal Name | GRANITE CITY EMERGENCY MEDICINE PROVIDERS LLC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Muhammad R Dalal | Family Medicine | Granite City Emergency Medicine Providers LLC | 2100 Madison Ave, Granite City, IL 62040-4713 |
| Debabrata Ray | Emergency Medicine | Granite City Emergency Medicine Providers LLC | 2100 Madison Ave, Granite City, IL 62040-4713 |
| Melissa Bounds | Nurse Practitioner | Granite City Emergency Medicine Providers LLC | 2100 Madison Ave, Granite City, IL 62040-4713 |
| Street Address |
2100 MADISON AVE |
| City | GRANITE CITY |
| State | IL |
| Zip | 62040-4713 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Victoria A Cullen | Clinical Social Worker | Granite City Clinic Corp | 2100 Madison Ave, Suite 201, Granite City, IL 62040-4713 |
| Saulius Kalvaitis | Cardiac Electrophysiology | Cardiac Cin of St Louis LLC | 2100 Madison Ave, Granite City, IL 62040-4713 |
| Kevin Kuria | Nurse Practitioner | Granite City Hospitalist Services LLC | 2100 Madison Ave, Granite City, IL 62040-4713 |
| Serge Marinkovic | Urology | Granite City Clinic Corp | 2100 Madison Ave, Suite 201, Granite City, IL 62040-4713 |
| Brian J Reach | Family Medicine | Granite City Hospitalist Services LLC | 2100 Madison Ave, Granite City, IL 62040-4713 |
| Anahit Singh Cheema | Nephrology | Inderjit Singh Md Facp LLC | 2100 Madison Ave, Granite City, IL 62040-4701 |
| Boris Khariton | Physical Medicine and Rehabilitation | 2100 Madison Ave, Granite City, IL 62040-4701 | |
| Zeeshan Naseer Ahmad | Internal Medicine | Granite City Hospitalist Services LLC | 2100 Madison Ave, Granite City, IL 62040-4713 |
| Timothy Hipskind | Internal Medicine | Granite City Hospitalist Services LLC | 2100 Madison Ave, Granite City, IL 62040-4713 |
| Megan Danielle Wood | Internal Medicine | Granite City Clinic Corp | 2100 Madison Ave, Suite 201, Granite City, IL 62040-4713 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John W Darr | Clinical Social Worker | 1635 W 1st St, Suite 110, Granite City, IL 62040-1883 | |
| Rita A Tucker | Nurse Practitioner | Westco Haggerty Medical Partners, P.a. | 3500 Century Dr, Granite City, IL 62040-2166 |
| Valerie J Barber | Optometry | 4182 Nameoki Rd, Granite City, IL 62040-2330 | |
| Mark Alan Kleindorfer | Optometry | 1801 Pontoon Rd, Granite City, IL 62040-2338 | |
| Alice Halliday | Nurse Practitioner | Granite City Urgent Care Walk-in Clinic | 2861 Madison Ave, Granite City, IL 62040-3614 |
| Danielle Homan | Physician Assistant | Granite City Urgent Care Walk-in Clinic | 2861 Madison Ave, Granite City, IL 62040-3614 |
| Stephanie Boerding | Nurse Practitioner | Granite City Urgent Care Walk-in Clinic | 2861 Madison Ave, Granite City, IL 62040-3614 |
| Ashley Marie Hynes | Physician Assistant | Granite City Urgent Care Walk-in Clinic | 2861 Madison Ave, Granite City, IL 62040-3614 |
| Robert J Montgomery | Physician Assistant | Granite City Urgent Care Walk-in Clinic | 2861 Madison Ave, Granite City, IL 62040-3614 |
| Andrew L Dorough | Chiropractic | Dr E L Strotheide Ltd | 3412 Nameoki Rd, Granite City, IL 62040-3702 |
| Find all physicians in zip 62040 | |||
| City | GRANITE CITY |
| Zip Code | 62040 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | GRANITE CITY + EMERGENCY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.