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ELLEN M. GRIMM MD
NPI 1275500100
Internal Medicine - Nephrology in San Marcos, TX

Active since February 28, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1330 WONDER WORLD DR, SAN MARCOS, TX 78666(512) 805-0680(512) 805-0682 Get Directions Write a Review

NPPES record last updated: February 1, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 1, 2022, Feb 14, 2016 (2 updates tracked since 2016).

About Ellen M. Grimm Md NPPES

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

ELLEN M. GRIMM MD (NPI 1275500100) is an individual nephrology provider in San Marcos, Texas, licensed in Texas (J4170) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS, is affiliated with Christus Santa Rosa Hospital-san Marcos, and is a graduate of University Of Texas Medical School At Houston (1992).

NPPES Registry Identity

NPI1275500100
Entity TypeIndividualFemale
Primary Taxonomy207RN0300X
Provider Legal NameELLEN M. GRIMMCredential: MD
Location Address1330 WONDER WORLD DRSan Marcos, TX 78666-7566
Mailing Address12221 N Mopac ExpyAustin, TX 78758-2401 · (512) 805-0680 · Fax (512) 805-0682
Phone(512) 805-0680
Fax(512) 805-0682
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At HoustonGraduated 1992
Enumeration DateFebruary 28, 2006
Last NPPES UpdateFebruary 1, 20222 updates tracked since enumeration
✔ NPI 1275500100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in TX · J4170
Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

1330 WONDER WORLD DR, San Marcos, TX 78666
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Other Identifiers 3

Medicaid101802004TX
Medicaid101802002TX
Other390007009TX · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ellen M. Grimm Md 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 ID9638174493
PECOS Enrollment IDI20090130000095
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.

Areas of Expertise CMS Part B claims 11

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.

Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
205 services36 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
154 services82 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
142 services57 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
114 services39 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
75 services52 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
44 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Christus Santa Rosa Hospital-San Marcos

Acute Care Hospitals · San Marcos, TX
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450272
Location1301 Wonder World DriveSan Marcos, TX 78666 · Hays County
Emergency services Birthing friendly

St David's South Austin Medical Center

Acute Care Hospitals · Austin, TX
5/5 CMS rating
OwnershipProprietary
CMS Certification Number450713
Location901 West Ben White BlvdAustin, TX 78704 · Travis County
Emergency services Birthing friendly

Ascension Seton Hays

Acute Care Hospitals · Kyle, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670056
Location6001 Kyle PkwyKyle, TX 78640 · Hays County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78666 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

e-Prescribing
94%299 patients2/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
100%156 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Cyclosporine, oral, 100 mg J7502
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers14 claims840 services$1.58 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
6 suppliers42 claims3,285 services$0.27 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
5 suppliers35 claims3,660 services$0.17 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
6 suppliers51 claims51 services$17.46 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
5 suppliers41 claims47 services$12.10 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BOGUSLAW GODLEWSKI MD
Internal Medicine (Cardiovascular Disease)
1330 WONDER WORLD DR, STE B108
SAN MARCOS, TX 78666
Hays County (512) 396-5603
SAN MARCOS MRI, LP
Clinic/Center (Radiology)
1330 WONDER WORLD DR, STE 202
SAN MARCOS, TX 78666
Hays County (512) 353-5535
BILLIE KAREN MARTIN PA
Physician Assistant (Medical)
1330 WONDER WORLD DR, STE B108
SAN MARCOS, TX 78666
Hays County (512) 396-5603
KING AND COURT IMAGING, PLLC
Radiology (Diagnostic Radiology)
1330 WONDER WORLD DR, STE 202
SAN MARCOS, TX 78666
Hays County (512) 396-8565
DR. CURTIS SCOTT SOLOMON MD
Internal Medicine (Interventional Cardiology)
1330 WONDER WORLD DR, SUITE B108
SAN MARCOS, TX 78666
Hays County (512) 396-5603
VIGOR AND VITALITY, LLC
Physical Medicine & Rehabilitation
1330 WONDER WORLD DR, STE 104
SAN MARCOS, TX 78666
Hays County (512) 353-5600
WILLIAM PETER ABIDE JR. M.D.
Internal Medicine (Cardiovascular Disease)
1330 WONDER WORLD DR, B-108
SAN MARCOS, TX 78666
Hays County (512) 396-5603

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 Ellen Grimm's NPI number?

The NPI number for Ellen Grimm is 1275500100. It was assigned to this individual provider in the NPPES registry on February 28, 2006.

Where is Ellen Grimm located?

Ellen Grimm practices at 1330 Wonder World Dr, San Marcos, TX 78666. The listed phone number is (512) 805-0680.

What is Ellen Grimm's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Ellen Grimm enrolled in Medicare?

Yes. Ellen Grimm 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.

What insurance does Ellen Grimm accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 5 other insurers list Ellen Grimm 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 Ellen Grimm affiliated with any hospitals?

According to CMS data, Ellen Grimm is affiliated with Christus Santa Rosa Hospital-San Marcos, St David's South Austin Medical Center and Ascension Seton Hays.

When was this NPI record last updated?

The NPPES record for Ellen Grimm was last updated on February 1, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.