Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. TIMOTHY J GRISSOM M.D.
NPI 1386695542
Radiology - Diagnostic Radiology in Fort Wayne, IN

Q: What is Timothy Grissom's NPI number?

The NPI number for Timothy Grissom is 1386695542. It was assigned to this individual provider in the NPPES registry on May 13, 2006.

Q: What is Timothy Grissom's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Timothy Grissom was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 36 days 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.

Active since May 13, 2006

2200 RANDALLIA DR, FORT WAYNE, IN 46805(260) 373-4731 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Timothy J Grissom M.d. NPPES

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

DR. TIMOTHY J GRISSOM M.D. (NPI 1386695542) is an individual diagnostic radiology provider in Fort Wayne, Indiana, licensed in Indiana (01050244) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1386695542

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameDR. TIMOTHY J GRISSOMCredential: M.D.

Location Address2200 RANDALLIA DRFort Wayne, IN 46805-4638

Mailing Address3707 New Vision DrFort Wayne, IN 46845-1702 · (260) 471-9466 · Fax (260) 484-5919

Phone(260) 373-4731

Sole ProprietorNo

Enumeration DateMay 13, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1386695542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in IN · 01050244

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

2200 RANDALLIA DR, Fort Wayne, IN 46805

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Other Identifiers 1

Other000000092616IN · Anthem

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.

Reported Quality Measures

Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques

Percentage of final reports for patients aged 18 years and older undergoing CT with documentation that one or more of the following dose reduction techniques were used: - Automated exposure control - Adjustment of the mA and/or kV according to patient size -…

98%549 patients

Radiology: Stenosis Measurement in Carotid Imaging Reports

Percentage of final reports for carotid imaging studies (neck magnetic resonance angiography [MRA], neck computed tomography angiography [CTA], neck duplex ultrasound, carotid angiogram) performed that include direct or indirect reference to measurements of…

100%52 patients

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.

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.

MALLIKA GYAWALI MD

Internal Medicine