MR. MITCHELL LEE GRESHAM JR.
NPI 1437622883
Counselor - Professional in San Diego, CA
About Mr. Mitchell Lee Gresham Jr. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. MITCHELL LEE GRESHAM JR. (NPI 1437622883) is an individual professional provider in San Diego, California, licensed in California (21573) and active in the NPI registry since January 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2016).
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 (PECOS)
Mr. Mitchell Lee Gresham Jr. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Mitchell Gresham reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Diego, CA 92108
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
San Jose, CA 95113
- Reassigned Medicare billing, California enrollment
- 3,139 clinicians in this Medicare group
Miami, FL 33130
- Reassigned Medicare billing, District of Columbia enrollment
- 1,424 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.
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.
SAN DIEGO, CA 92154
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 Mitchell Gresham's NPI number?
The NPI number for Mitchell Gresham is 1437622883. It was assigned to this individual provider in the NPPES registry on January 8, 2019.
Where is Mitchell Gresham located?
Mitchell Gresham practices at 4660 Palm Ave, San Diego, CA 92154. The listed phone number is (183) 357-9484.
What is Mitchell Gresham's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Mitchell Gresham enrolled in Medicare?
Yes. Mitchell Gresham is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Mitchell Gresham's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mitchell Gresham reassigns Medicare benefits to 3 organizations: Southern California Permanente Medical Group (San Diego, CA), Grow Healthcare Group PC (San Jose, CA) and Grow Healthcare Group PA (Miami, FL). 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 Mitchell Gresham'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 Mitchell Gresham was last updated on June 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Mr. Mitchell Lee Gresham Jr. · NPI 1437622883
Professional provider in San Diego, California. Individual provider, active in the CMS NPPES registry since January 8, 2019.
## Identity
- **NPI:** 1437622883 (Entity type: Individual)
- **Enumerated:** January 8, 2019
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 21573 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4660 PALM AVE, San Diego, CA 92154-8404
- **Phone:** (183) 357-9484
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Southern California Permanente Medical Group (NPI 1023425972, San Diego, CA); Grow Healthcare Group PC (NPI 1154994846, San Jose, CA); Grow Healthcare Group PA (NPI 1245845932, Miami, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** June 19, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1437622883) · Data from the CMS NPPES public registry.