ALYSSA GRISSOM (APN, AGCNS) – Oncology Clinical Nurse Specialist, NPI 1790213932

ALYSSA GRISSOM (APN, AGCNS) is a healthcare provider. based in Cedar rapids, Iowa. specializing in NURSE PRACTITIONER. They hold the professional credentials APN, AGCNS. They hold a License No. 209014163 (IL). The NPI Number for ALYSSA GRISSOM (APN, AGCNS) is 1790213932

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
ALYSSA GRISSOM (APN, AGCNS)
NPI
1790213932
Phone
(319) 369-7816
Address
202 10TH ST SE STE 285
Enumeration Date
1 June 2017
Last Update Date
30 April 2024

Doctor Profile

Medical School Name
LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Secondary Phone
3193685757
Graduation Year
2015 (11 years ago)
PAC ID
5698117612
Group Practice PAC ID
6608786751
Professional Enrollment ID
I20240522002769
Address ID
IA524025036CE1026XNEXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:9State licenses:2Digital endpointsOther names

11,637 NURSE PRACTITIONER in IL

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Provider Addresses for ALYSSA GRISSOM (APN, AGCNS)

  • 202 10TH ST SE STE 285

    CEDAR RAPIDS, IA 524032437

    Phone: (319) 369-7816

    Type: Mailing

  • 9436 S KOLMAR AVE APT 2A

    OAK LAWN, IL 604532694

    Phone: (937) 248-3166

    Type: Mailing

  • Advocate Children's Hospital, 4440, West 95th Street, Oak Lawn, Worth Township, Cook County, Illinois, 60453, United States

    8TH FLOOR OUTPATIENT PAVILLION

    OAK LAWN, IL 60453

    Phone: (708) 684-2064

    Type: Location

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: 2024-05-22

PECOS data refreshed: 2026-05-27

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
I20240522002769INurse PractitionerIATBD

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 52403)

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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: 6608786751View full group profile
NameSpecialtyState
Internal Medicine, Cardiovascular Disease (Cardiology)IA
Nurse PractitionerIA
Nurse PractitionerIA
Nurse PractitionerIA
-IA
-IA
Clinical PsychologistIA
Nurse PractitionerIA
-IA
P S Y C H I A T R YIA

Reviews

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Frequently asked questions

What unique ID ties claims to ALYSSA GRISSOM (APN, AGCNS)?
NPI 1790213932 is assigned to ALYSSA GRISSOM (APN, AGCNS) under the national enumeration system.
Does this profile mean ALYSSA GRISSOM (APN, AGCNS) is currently active?
Yes — ALYSSA GRISSOM (APN, AGCNS) appears active in the national provider directory.
What does ALYSSA GRISSOM (APN, AGCNS) treat or focus on?
Patients typically see ALYSSA GRISSOM (APN, AGCNS) under the specialty Oncology Clinical Nurse Specialist. Clinical services aligned with this taxonomy classification.
What location shows for ALYSSA GRISSOM (APN, AGCNS)?
We surface Cedar Rapids, Iowa for ALYSSA GRISSOM (APN, AGCNS) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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