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SARA MARIE GROTEFENDT NP
NPI 1255805594
Nurse Practitioner - Obstetrics & Gynecology in Maryville, IL

Active since January 21, 2019PECOS EnrolledAccepts Medicare Assignment
6810 STATE ROUTE 162 STE 105, MARYVILLE, IL 62062(618) 288-9320(618) 288-9258 Get Directions Write a Review

NPPES record last updated: August 28, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sara Marie Grotefendt Np NPPES

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

SARA MARIE GROTEFENDT NP (NPI 1255805594) is an individual obstetrics & gynecology provider in Maryville, Illinois, licensed in Illinois (209017373) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS, is affiliated with Anderson Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1255805594
Entity TypeIndividualFemale
Primary Taxonomy363LX0001X
Provider Legal NameSARA MARIE GROTEFENDTCredential: NP
Location Address6810 STATE ROUTE 162 STE 105Maryville, IL 62062-8560
Mailing Address6810 State Route 162, Box 215Maryville, IL 62062 · (618) 391-6495
Phone(618) 288-9320
Fax(618) 288-9258
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJanuary 21, 2019
Last NPPES UpdateAugust 28, 2024
NPPES CertifiedAugust 28, 2024
✔ NPI 1255805594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Obstetrics & GynecologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LX0001X
License✔ Licensed in IL · 209017373
6810 STATE ROUTE 162 STE 105, Maryville, IL 62062
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield and more.Insurance ›

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

Sara Marie Grotefendt Np 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.

PECOS PAC ID8820339740
PECOS Enrollment IDI20190402002622
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 Sara Grotefendt reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Anderson Medical Group, LLC
Same address
General Practice
6810 STATE ROUTE 162, SUITE 215
Maryville, IL 62062
  • Reassigned Medicare billing, Illinois enrollment
  • 145 clinicians in this Medicare group
NPI 1700807716 (618) 288-5711
Southern Obstetric & Gyneco Associates
15 mi
Obstetrics & Gynecology
1328 MERCANTILE DR
Highland, IL 62249
  • Reassigned Medicare billing, Illinois enrollment
  • 10 clinicians in this Medicare group
NPI 1962793687 (618) 654-4836

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 2

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.

Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
30 services30 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
16 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Anderson Hospital

Acute Care Hospitals · Maryville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140289
Location6800 State Route 162Maryville, IL 62062 · Madison County
Emergency services Birthing friendly

Community Hospital Of Staunton

Critical Access Hospitals · Staunton, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141306
Location400 N Caldwell StStaunton, IL 62088 · Macoupin County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62062 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
Established Patient
$99.71 typical visit price
range $17.51 – $139.99
Typical copayment $24.92 (range $4.37 – $34.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Sara Grotefendt's NPI number?

The NPI number for Sara Grotefendt is 1255805594. It was assigned to this individual provider in the NPPES registry on January 21, 2019.

Where is Sara Grotefendt located?

Sara Grotefendt practices at 6810 State Route 162 Ste 105, Maryville, IL 62062. The listed phone number is (618) 288-9320.

What is Sara Grotefendt's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Obstetrics & Gynecology, with taxonomy code 363LX0001X.

Is Sara Grotefendt enrolled in Medicare?

Yes. Sara Grotefendt 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 Sara Grotefendt's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sara Grotefendt reassigns Medicare benefits to 2 organizations: Anderson Medical Group, LLC (Maryville, IL) and Southern Obstetric & Gyneco Associates (Highland, IL). 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 Sara Grotefendt's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sara Grotefendt accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield and UnitedHealthcare list Sara Grotefendt 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.

Is Sara Grotefendt affiliated with any hospitals?

According to CMS data, Sara Grotefendt is affiliated with Anderson Hospital and Community Hospital Of Staunton.

When was this NPI record last updated?

The NPPES record for Sara Grotefendt was last updated on August 28, 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.