DAULTON K. GRUBE MD - NPI 1790434801 - Pediatrics in Cheyenne, WY

Q: What is Daulton Grube's NPI number?

The NPI number for Daulton Grube is 1790434801. It was assigned to this individual provider in the NPPES registry on March 23, 2022.

Q: What is Daulton Grube's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Daulton Grube was last updated on December 16, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Daulton K. Grube Md NPPES

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

DAULTON K. GRUBE MD (NPI 1790434801) is an individual pediatrics provider in Cheyenne, Wyoming, licensed in Wyoming (18656A) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, maintains a secondary practice location in Cheyenne, and is a graduate of University Of Washington School Of Medicine (2022).

NPPES Registry Identity

NPI1790434801

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDAULTON K. GRUBECredential: MD

Location Address2301 HOUSE AVE STE 405Cheyenne, WY 82001-3180

Mailing AddressPo Box 20970Cheyenne, WY 82003-7020 · (307) 996-4777 · Fax (307) 773-8013

Phone(307) 635-7961

Fax(307) 778-5812

Sole ProprietorNo

Medical School CMSUniversity Of Washington School Of MedicineGraduated 2022

Enumeration DateMarch 23, 2022

Last NPPES UpdateDecember 16, 20252 updates tracked since enumeration

NPPES CertifiedDecember 16, 2025

✔ NPI 1790434801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in WY · 18656A

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

2301 HOUSE AVE STE 405, Cheyenne, WY 82001

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Secondary Practice Location 1

Location 14116 Laramie StCheyenne, WY 82001-1969 · Phone (307) 635-7961 · Fax (307) 778-5814

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Daulton K. Grube Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4284097684

PECOS Enrollment IDI20250926000274

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 82001 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.12 typical visit price

range $56.42 – $170.72

Typical copayment $21.78 (range $14.10 – $42.68)

Most-billed visit code 99203

Established Patient

$99.46 typical visit price

range $18.19 – $139.32

Typical copayment $24.86 (range $4.54 – $34.83)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUSTIN MATTHEW ROMANO MD

Psychiatry & Neurology (Psychiatry)