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DR. DANIEL GRISSOM M.D.
NPI 1063943686
Pediatrics - Pediatric Emergency Medicine in Las Vegas, NV

Active since March 24, 2017PECOS Enrolled
1800 W CHARLESTON BLVD, LAS VEGAS, NV 89102(702) 383-1958 Get Directions Write a Review

NPPES record last updated: October 29, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 10, 2024, Mar 27, 2023, Aug 26, 2022 and 2 more (5 updates tracked since 2017).

About Dr. Daniel Grissom M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DANIEL GRISSOM M.D. (NPI 1063943686) is an individual pediatric emergency medicine provider in Las Vegas, Nevada, licensed in Nevada (24016) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063943686
Entity TypeIndividualMale
Primary Taxonomy2080P0204X
Provider Legal NameDR. DANIEL GRISSOMCredential: M.D.
Location Address1800 W CHARLESTON BLVDLas Vegas, NV 89102-2386
Mailing Address1800 W Charleston BlvdLas Vegas, NV 89102-2386 · (702) 383-2000
Phone(702) 383-1958
Sole ProprietorNo
Enumeration DateMarch 24, 2017
Last NPPES UpdateOctober 29, 20245 updates tracked since enumeration
NPPES CertifiedOctober 29, 2024
✔ NPI 1063943686 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in NV · 24016
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
Also ListedPediatricsTaxonomy 208000000X · License 01084383A (IN)
1800 W CHARLESTON BLVD, Las Vegas, NV 89102
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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. Daniel Grissom M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Daniel Grissom reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Medical Center Of Southern Nevada
Same address
General Acute Care Hospital
1800 W. CHARLESTON BLVD.
Las Vegas, NV 89102
  • Reassigned Medicare billing, Nevada enrollment
  • 522 clinicians in this Medicare group
NPI 1548393127 (702) 383-2000
Sound Physicians Emergency Medicine Of Nevada Bessler PLLC
340 mi
Emergency Medicine
2375 E PRATER WAY
Sparks, NV 89434
  • Reassigned Medicare billing, Nevada enrollment
  • 117 clinicians in this Medicare group
NPI 1881151231 (775) 331-7000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

MICHAEL M LEE MD
Internal Medicine
1800 W CHARLESTON BLVD
LAS VEGAS, NV 89102
Clark County (702) 921-6823
DR. ALAN MICHAEL ZETO JR. MD
Family Medicine
1800 W CHARLESTON BLVD
LAS VEGAS, NV 89102
Clark County (702) 207-8263
DR. ADAM MCLEAN MURRAY MD
Student in an Organized Health Care Education/Training Program
1800 W CHARLESTON BLVD
LAS VEGAS, NV 89102
Clark County (702) 671-2385
YOUNG SUK SONG M.D.
Radiology (Diagnostic Radiology)
1800 W CHARLESTON BLVD
LAS VEGAS, NV 89102
Clark County (702) 383-2000
EMERGENCY MEDICINE PHYSICIANS OF CLARK PEDIATRICS MCCOURT, PLLC
Emergency Medicine
1800 W CHARLESTON BLVD
LAS VEGAS, NV 89102
Clark County (702) 383-2085
LORI NICOLE WATSON RD
Dietitian, Registered
1800 W CHARLESTON BLVD
LAS VEGAS, NV 89102
Clark County (405) 863-7068
GABRIELA AGUIRRE RD
Dietitian, Registered
1800 W CHARLESTON BLVD
LAS VEGAS, NV 89102
Clark County (702) 383-0000
GIAN FULE CRNA
Nurse Anesthetist, Certified Registered
1800 W CHARLESTON BLVD
LAS VEGAS, NV 89102
Clark County (702) 383-2000

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 Daniel Grissom's NPI number?

The NPI number for Daniel Grissom is 1063943686. It was assigned to this individual provider in the NPPES registry on March 24, 2017.

Where is Daniel Grissom located?

Daniel Grissom practices at 1800 W Charleston Blvd, Las Vegas, NV 89102. The listed phone number is (702) 383-1958.

What is Daniel Grissom's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Daniel Grissom enrolled in Medicare?

Yes. Daniel Grissom is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Daniel Grissom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Daniel Grissom reassigns Medicare benefits to 2 organizations: University Medical Center Of Southern Nevada (Las Vegas, NV) and Sound Physicians Emergency Medicine Of Nevada Bessler PLLC (Sparks, NV). 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 Daniel Grissom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Daniel Grissom accept?

Health plans from CareSource list Daniel Grissom 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 Daniel Grissom was last updated on October 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.