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TIRSA ARLYN RANDALL-GRUTTER
NPI 1568216851
Student in an Organized Health Care Education/Training Program in Pomona, CA

Active since April 15, 2024PECOS Enrolled
309 E 2ND ST, POMONA, CA 91766(909) 469-5589 Get Directions Write a Review

NPPES record last updated: April 15, 2024. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Tirsa Arlyn Randall-grutter NPPES

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

TIRSA ARLYN RANDALL-GRUTTER (NPI 1568216851) is an individual student in an organized health care education/training program in Pomona, California and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568216851
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameTIRSA ARLYN RANDALL-GRUTTER
Location Address309 E 2ND STPomona, CA 91766-1854
Mailing Address309 E 2nd StPomona, CA 91766-1854 · (909) 469-5589
Phone(909) 469-5589
Sole ProprietorNo
Enumeration DateApril 15, 2024
NPPES CertifiedApril 14, 2024
✔ NPI 1568216851 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
309 E 2ND ST, Pomona, CA 91766
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tirsa Arlyn Randall-grutter is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

NANCY IRENE NIELSEN-BROWN PA-C
Physician Assistant (Medical)
309 E 2ND ST
POMONA, CA 91766
Los Angeles County (909) 469-5386
BRITTNEY TUNON
Physician Assistant
309 E 2ND ST
POMONA, CA 91766
Los Angeles County (703) 955-6286
MR. EVAN HERSHMAN
Student in an Organized Health Care Education/Training Program
309 E 2ND ST
POMONA, CA 91766
Los Angeles County (909) 469-5589
CHAU MINH NGUYEN PA-C
Physician Assistant
309 E 2ND ST
POMONA, CA 91766
Los Angeles County (951) 892-4858
AMI PATEL
Student in an Organized Health Care Education/Training Program
309 E 2ND ST
POMONA, CA 91766
Los Angeles County (909) 469-5589
MR. FOUAD HAJJAR
Student in an Organized Health Care Education/Training Program
309 E 2ND ST
POMONA, CA 91766
Los Angeles County (909) 469-5589
THAO BICH VU
Student in an Organized Health Care Education/Training Program
309 E 2ND ST
POMONA, CA 91766
Los Angeles County (909) 469-5589
JULIA B DIAMANT
Student in an Organized Health Care Education/Training Program
309 E 2ND ST
POMONA, CA 91766
Los Angeles County (909) 469-5589

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 Tirsa Randall-grutter's NPI number?

The NPI number for Tirsa Randall-grutter is 1568216851. It was assigned to this individual provider in the NPPES registry on April 15, 2024.

Where is Tirsa Randall-grutter located?

Tirsa Randall-grutter practices at 309 E 2nd St, Pomona, CA 91766. The listed phone number is (909) 469-5589.

What is Tirsa Randall-grutter's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Tirsa Randall-grutter enrolled in Medicare?

Yes. Tirsa Randall-grutter is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tirsa Randall-grutter was last updated on April 15, 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.