DR. GRADY AUSBUR FORTNER M.D.
NPI 1043636202
Emergency Medicine in Jacksonville, FL
About Dr. Grady Ausbur Fortner M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. GRADY AUSBUR FORTNER M.D. (NPI 1043636202) is an individual emergency medicine provider in Jacksonville, Florida, licensed in Guam (M-2191) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Grady Ausbur Fortner M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Grady Fortner reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Baton Rouge, LA 70815
- Reassigned Medicare billing, Louisiana enrollment
- 48 clinicians in this Medicare group
Baton Rouge, LA 70808
- Reassigned Medicare billing, Louisiana enrollment
- 147 clinicians in this Medicare group
Dededo, GU 96929
- Reassigned Medicare billing, Guam enrollment
- 432 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32212 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
JACKSONVILLE, FL 32212
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Grady Fortner's NPI number?
The NPI number for Grady Fortner is 1043636202. It was assigned to this individual provider in the NPPES registry on March 12, 2014.
Where is Grady Fortner located?
Grady Fortner practices at 554 Keily Street, Jacksonville, FL 32212. The listed phone number is (757) 953-7550.
What is Grady Fortner's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Grady Fortner enrolled in Medicare?
Yes. Grady Fortner is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Grady Fortner's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Grady Fortner reassigns Medicare benefits to 3 organizations: Woman's Assessment Center Physicians (Baton Rouge, LA), Professional Emergency Physician Associates, LLC (Baton Rouge, LA) and Guam Healthcare Development Incorporated (Dededo, GU). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Grady Fortner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Grady Fortner accept?
Health plans from HMO Louisiana list Grady Fortner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Grady Fortner was last updated on December 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Grady Ausbur Fortner, M.D. · NPI 1043636202
Emergency Medicine physician in Jacksonville, Florida. Individual provider, active in the CMS NPPES registry since March 12, 2014.
## Identity
- **NPI:** 1043636202 (Entity type: Individual)
- **Enumerated:** March 12, 2014
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** M-2191 (GU)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 554 KEILY STREET, Jacksonville, FL 32212
- **Phone:** (757) 953-7550 · **Fax:** (757) 953-7560
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Woman's Assessment Center Physicians (NPI 1205019908, Baton Rouge, LA); Professional Emergency Physician Associates, LLC (NPI 1992758247, Baton Rouge, LA); Guam Healthcare Development Incorporated (NPI 1326447939, Dededo, GU) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 17, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1043636202) · Data from the CMS NPPES public registry.