GRANT NYBAKKEN M.D.
NPI 1104088400
Pathology - Clinical Pathology/Laboratory Medicine in South San Francisco, CA
About Grant Nybakken M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRANT NYBAKKEN M.D. (NPI 1104088400) is an individual clinical pathology/laboratory medicine provider in South San Francisco, California, licensed in Pennsylvania (MT193042) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS and is a graduate of Washington University School Of Medicine (2008).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Grant Nybakken M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Grant Nybakken reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Burlingame, CA 94010
- Reassigned Medicare billing, California enrollment
- 17 clinicians in this Medicare group
San Francisco, CA 94116
- Reassigned Medicare billing, California enrollment
- 20,078 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 94080 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 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SOUTH SAN FRANCISCO, CA 94080
SOUTH SAN FRANCISCO, CA 94080
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 Grant Nybakken's NPI number?
The NPI number for Grant Nybakken is 1104088400. It was assigned to this individual provider in the NPPES registry on June 27, 2008.
Where is Grant Nybakken located?
Grant Nybakken practices at 383 E Grand Ave Ste A, South San Francisco, CA 94080. The listed phone number is (650) 616-2951.
What is Grant Nybakken's specialty?
The primary specialty registered for this NPI is Pathology, specializing in Clinical Pathology/Laboratory Medicine, with taxonomy code 207ZP0105X.
Is Grant Nybakken enrolled in Medicare?
Yes. Grant Nybakken is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Grant Nybakken's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Grant Nybakken reassigns Medicare benefits to 2 organizations: Peninsula Pathologists Medical Group Inc. (Burlingame, CA) and Permanente Medical Group Inc (San Francisco, CA). 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 Grant Nybakken's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Grant Nybakken was last updated on November 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.
# Grant Nybakken, M.D. · NPI 1104088400
Clinical Pathology/Laboratory Medicine physician in South San Francisco, California. Individual provider, active in the CMS NPPES registry since June 27, 2008.
## Identity
- **NPI:** 1104088400 (Entity type: Individual)
- **Enumerated:** June 27, 2008
- **Primary specialty:** Pathology - Clinical Pathology/Laboratory Medicine · taxonomy 207ZP0105X
- **State license:** MT193042 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 383 E GRAND AVE STE A, South San Francisco, CA 94080-6234
- **Phone:** (650) 616-2951
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Peninsula Pathologists Medical Group Inc. (NPI 1285699793, Burlingame, CA); Permanente Medical Group Inc (NPI 1841373800, San Francisco, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Washington University School Of Medicine, class of 2008
## Record status
- **NPPES last updated:** November 22, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1104088400) · Data from the CMS NPPES public registry.