DYLAN THOMAS GRONSET (DO) – Emergency Medicine Physician, NPI 1043905268

DYLAN THOMAS GRONSET (DO) is a healthcare provider. based in Peoria, Illinois. specializing in EMERGENCY MEDICINE. They hold the professional credentials DO. They hold a License No. 036176491 (IL). The NPI Number for DYLAN THOMAS GRONSET (DO) is 1043905268

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
DYLAN THOMAS GRONSET (DO)
NPI
1043905268
Phone
(309) 655-2109
Address
530 NE GLEN OAK AVE
Enumeration Date
5 April 2023
Last Update Date
7 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3096615111
Graduation Year
2023 (3 years ago)
PAC ID
1355827981
Group Practice PAC ID
3274793633
Professional Enrollment ID
I20260113002537
Address ID
IL617014364BL2200XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:3State licenses:1Digital endpointsOther names

2,860 EMERGENCY MEDICINE in IL

Provider Addresses for DYLAN THOMAS GRONSET (DO)

  • 530 NE GLEN OAK AVE

    PEORIA, IL 616370001

    Phone: (309) 655-2109

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-01-13

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260113002537IEmergency MedicineILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61637)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274793633View full group profile
NameSpecialtyState
Nurse PractitionerIL
Emergency MedicineMI
-IL
Emergency MedicineWI
Emergency MedicineCA
Emergency MedicineAR
Nurse PractitionerIL
Emergency MedicineIL
Emergency Medicine, Internal MedicineMO
Emergency MedicineMO

Reviews

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Frequently asked questions

How do I look up DYLAN THOMAS GRONSET (DO) by NPI?
Use NPI 1043905268 when you need to reference DYLAN THOMAS GRONSET (DO) in forms, claims, or directories.
Is DYLAN THOMAS GRONSET (DO)'s NPI currently valid?
The extract we use shows DYLAN THOMAS GRONSET (DO) as active.
Does DYLAN THOMAS GRONSET (DO) list a primary specialty?
If you are matching referrals, note Emergency Medicine Physician for DYLAN THOMAS GRONSET (DO). Clinical services aligned with this taxonomy classification.
Where does public data place DYLAN THOMAS GRONSET (DO)?
The snapshot lists Peoria, Illinois for DYLAN THOMAS GRONSET (DO); download NPPES for the complete set.
How can I contact DYLAN THOMAS GRONSET (DO)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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