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DR. JASON RAFAEL GRULLON MD
NPI 1568253169
Student in an Organized Health Care Education/Training Program in Williamsport, PA

Active since May 14, 2025PECOS Enrolled
740 HIGH ST STE 4001, WILLIAMSPORT, PA 17701(570) 321-3520 Get Directions Write a Review

NPPES record last updated: May 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jason Rafael Grullon Md NPPES

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

DR. JASON RAFAEL GRULLON MD (NPI 1568253169) is an individual student in an organized health care education/training program in Williamsport, Pennsylvania and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568253169
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JASON RAFAEL GRULLONCredential: MD
Location Address740 HIGH ST STE 4001Williamsport, PA 17701-3111
Mailing Address3600 Forbes Ave Ste 140Pittsburgh, PA 15213-3410
Phone(570) 321-3520
Sole ProprietorNo
Enumeration DateMay 14, 2025
NPPES CertifiedMay 14, 2025
✔ NPI 1568253169 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.
740 HIGH ST STE 4001, Williamsport, PA 17701
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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)

Dr. Jason Rafael Grullon Md 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.

KYLE OTTO MD
Student in an Organized Health Care Education/Training Program
740 HIGH ST STE 4001
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-2345
DR. CEILIA SEVERINI DO
Student in an Organized Health Care Education/Training Program
740 HIGH ST STE 4001
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-3567
EMILY SNELL D.O.
Student in an Organized Health Care Education/Training Program
740 HIGH ST STE 4001
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-2345
COURTNEY LEIGH GOETTEL MD
Family Medicine
740 HIGH ST STE 4001
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-2345
DR. JOSHUA P MOREE MD, DC
Family Medicine
740 HIGH ST STE 4001
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-2336
HANNAH MARIE TERZ
Student in an Organized Health Care Education/Training Program
740 HIGH ST STE 4001
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-2345
LAM NGUYEN CHAU MD
Student in an Organized Health Care Education/Training Program
740 HIGH ST STE 4001
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-2345
MICHAEL ANDREW KOVALICK JR.
Student in an Organized Health Care Education/Training Program
740 HIGH ST STE 4001
WILLIAMSPORT, PA 17701
Lycoming County (800) 837-2011

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 Jason Grullon's NPI number?

The NPI number for Jason Grullon is 1568253169. It was assigned to this individual provider in the NPPES registry on May 14, 2025.

Where is Jason Grullon located?

Jason Grullon practices at 740 High St Ste 4001, Williamsport, PA 17701. The listed phone number is (570) 321-3520.

What is Jason Grullon's specialty?

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

Is Jason Grullon enrolled in Medicare?

Yes. Jason Grullon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jason Grullon was last updated on May 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.