JACOB GRISHAM FNP
NPI 1417776196
Nurse Practitioner - Family in Newburgh, IN
About Jacob Grisham Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACOB GRISHAM FNP (NPI 1417776196) is an individual family provider in Newburgh, Indiana, licensed in Indiana (71015844A) and active in the NPI registry since October 2024. He is enrolled in Medicare PECOS, is affiliated with Deaconess Hospital Inc, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Accepted 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
Jacob Grisham Fnp 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 Reassignment
Medicare enrollment records show Jacob Grisham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Newburgh, IN 47630
- Reassigned Medicare billing, Indiana enrollment
- 31 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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Deaconess Hospital Inc
Acute Care Hospitals · Evansville, INAscension St Vincent Evansville
Acute Care Hospitals · Evansville, INAscension St Vincent Warrick
Critical Access Hospitals · Boonville, INPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 47630 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEWBURGH, IN 47630
NEWBURGH, IN 47630
NEWBURGH, IN 47630
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 Jacob Grisham's NPI number?
The NPI number for Jacob Grisham is 1417776196. It was assigned to this individual provider in the NPPES registry on October 9, 2024.
Where is Jacob Grisham located?
Jacob Grisham practices at 3800 Venetian Way, Newburgh, IN 47630. The listed phone number is (812) 477-6103.
What is Jacob Grisham's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jacob Grisham enrolled in Medicare?
Yes. Jacob Grisham 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 organization bills Medicare for Jacob Grisham's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Grisham reassigns Medicare benefits to Digestive Care Of Evansville PC (Newburgh, IN). The 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 Jacob Grisham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacob Grisham accept?
Health plans from Anthem Blue Cross and Blue Shield and CareSource list Jacob Grisham 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 Jacob Grisham affiliated with any hospitals?
According to CMS data, Jacob Grisham is affiliated with Deaconess Hospital Inc, Ascension St Vincent Evansville and Ascension St Vincent Warrick.
When was this NPI record last updated?
The NPPES record for Jacob Grisham was last updated on May 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Jacob Grisham, FNP · NPI 1417776196
Family physician in Newburgh, Indiana. Individual provider, active in the CMS NPPES registry since October 9, 2024.
## Identity
- **NPI:** 1417776196 (Entity type: Individual)
- **Enumerated:** October 9, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 71015844A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 3800 VENETIAN WAY, Newburgh, IN 47630-8257
- **Phone:** (812) 477-6103 · **Fax:** (812) 469-3285
## 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:** Digestive Care Of Evansville PC (NPI 1376751891, Newburgh, IN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** May 13, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1417776196) · Data from the CMS NPPES public registry.