JUSTIN PAUL GRUBE (PA-C) – Physician Assistant, NPI 1811217417
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
324 PHYSICIAN ASSISTANT in WY
Provider Addresses for JUSTIN PAUL GRUBE (PA-C)
PO BOX 860912
MINNEAPOLIS, MN 554860912
Phone: (507) 284-2511
Type: Mailing
PO BOX 428
JACKSON, WY 830010428
Phone: (307) 739-7690
Fax: (307) 739-7644
Type: Mailing
555 E BROADWAY AVE STE 229
JACKSON, WY 83001
Phone: (307) 739-7690
Fax: (307) 739-7644
Type: Location
1400 BELLINGER STREET
EAU CLAIRE, WI 547035222
Phone: (715) 838-5222
Type: Location
411 Stageline Rd Ste 150
Hudson, WI 540167848
Phone: (715) 531-6700
Fax: (715) 531-6701
Type: Location
265 Griffin St E
Amery, WI 540011439
Phone: (715) 268-8000
Fax: (715) 268-0311
Type: Location
535 Hospital Rd
New Richmond, WI 540171449
Phone: (715) 243-3400
Fax: (715) 246-8980
Type: Location
200 1st St SW
Rochester, MN 559050001
Phone: (507) 284-2511
Type: Location
555 E Broadway Ave Ste 229
Jackson, WY 83001
Phone: (307) 739-7690
Fax: (307) 739-7644
Type: Location
945 W Broadway
Suite 202
Jackson, WY 830018217
Phone: (307) 734-5999
Fax: (307) 734-0345
Type: Location
625 E Broadway Ave
Jackson, WY 830018642
Phone: (307) 733-3636
Type: Location
1500 Curve Crest Blvd W
Stillwater, MN 550826040
Phone: (651) 439-1234
Fax: (651) 275-3325
Type: Location
200 1ST ST SW
ROCHESTER, MN 559050001
Phone: (507) 284-2511
Type: Mailing
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: 2023-12-18
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231218000920 | I | Physician Assistant | WI | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 49650 | Repair of groin hernia using an endoscope | 20 | 20 | $0 |
Insurance plans in this area (ZIP 55486)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| - | MN | |
| - | WI | |
| - | MN | |
| - | WI | |
| - | WI | |
| - | WI | |
| Clinical Psychologist | WI | |
| Nurse Practitioner | MN | |
| Pulmonary Disease | WI |
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