JENNIFER R GRUBA (PHD) – Clinical Psychologist, NPI 1033413646

JENNIFER R GRUBA (PHD) is a healthcare provider. based in Madison, Wisconsin. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 867-124 (WI). The NPI Number for JENNIFER R GRUBA (PHD) is 1033413646

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER R GRUBA (PHD)
NPI
1033413646
Phone
(608) 264-5342
Address
706 WILLIAMSON ST STE 4
Enumeration Date
23 December 2010
Last Update Date
4 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6087425518
Graduation Year
2023 (3 years ago)
PAC ID
3971953597
Group Practice PAC ID
8426948746
Professional Enrollment ID
I20250804003987
Address ID
WI539013403PO2901XTRLX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:15State licenses:2Digital endpointsOther names

667 CLINICAL PSYCHOLOGIST in WI

Provider Addresses for JENNIFER R GRUBA (PHD)

  • 706 WILLIAMSON ST STE 4

    MADISON, WI 537034658

    Phone: (608) 264-5342

    Fax: (608) 264-5344

    Type: Location

  • 710 N. WEBB AVE

    REEDSBURG, WI 53959

    Phone: (608) 524-5151

    Fax: (608) 524-5353

    Type: Mailing

  • 2901 HUNTERS TRL

    PORTAGE, WI 539013403

    Phone: (608) 742-5518

    Fax: (608) 742-4087

    Type: Location

  • 2625 Military Rd

    Cross Plains, WI 535289687

    Phone: (608) 617-6344

    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: 2025-08-04

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
I20250804003987IClinical PsychologistWITBD

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 53703)

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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: 8426948746View full group profile
NameSpecialtyState
-WI
Nurse PractitionerWI
Clinical Social WorkerWI
-WI
Mental Health CounselorWI
Clinical Social WorkerWI
Mental Health CounselorWI
Marriage And Family TherapistWI
Mental Health CounselorWI
Clinical Social WorkerWI

Reviews

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Frequently asked questions

What federal number belongs to JENNIFER R GRUBA (PHD)?
The federal identifier for JENNIFER R GRUBA (PHD) is NPI 1033413646.
Is JENNIFER R GRUBA (PHD)'s NPI currently valid?
The extract we use shows JENNIFER R GRUBA (PHD) as active.
What kind of provider is JENNIFER R GRUBA (PHD)?
The page reflects Clinical Psychologist for JENNIFER R GRUBA (PHD). Clinical services aligned with this taxonomy classification.
What location metadata exists for JENNIFER R GRUBA (PHD)?
The page summarizes Madison, Wisconsin for JENNIFER R GRUBA (PHD); expand the address list for detail.
What if Madison, Wisconsin seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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