Larry Jay Grong, DO is a medicare enrolled "Internal Medicine" physician in Dawson, Minnesota. His current practice location is
1282 Walnut St, Dawson, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(320) 769-7393.
Larry Jay Grong is licensed to practice in Minnesota (license number 39995) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1871653758.
Physician's Profile
| Full Name | Larry Jay Grong |
|---|
| Gender | Male |
|---|
| Speciality | Internal Medicine |
|---|
| Location | 1282 Walnut St, Dawson, Minnesota |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1871653758
- Provider Enumeration Date: 12/11/2006
- Last Update Date: 03/18/2022
Medicare PECOS Information:
- PECOS PAC ID: 8123060217
- Enrollment ID: I20050531000270
Medical Identifiers
Medical identifiers for Larry Jay Grong such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1871653758 | NPI | - | NPPES |
| 4150236-00 | Medicaid | MN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207R00000X | Internal Medicine | 39995 (Minnesota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Larry Jay Grong allows following entities to bill medicare on his behalf.
| Entity Name | Johnson Memorial Health Services |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1770697260 PECOS PAC ID: 5395653836 Enrollment ID: O20031223000327 |
|---|
| Entity Name | Swift County-benson Hospital |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1174529002 PECOS PAC ID: 8729069281 Enrollment ID: O20040528001145 |
|---|
| Entity Name | Appleton Area Health |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1730126673 PECOS PAC ID: 7618952565 Enrollment ID: O20060818000114 |
|---|
| Entity Name | Hendricks Community Hospital Assn & Retirement Home |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1013206812 PECOS PAC ID: 9830127356 Enrollment ID: O20110602000620 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larry Jay Grong is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Larry Jay Grong, DO 1282 Walnut St, Dawson, MN 56232-2333 Ph: (320) 769-7393 | Larry Jay Grong, DO 1282 Walnut St, Dawson, MN 56232 Ph: (320) 769-7393 |
Reviews and Comments