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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since March 23, 2022PECOS Enrolled

2301 HOUSE AVE STE 405, CHEYENNE, WY 82001(307) 635-7961(307) 778-5812 Get Directions Write a Review

NPPES record last updated: December 16, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 16, 2025, Aug 10, 2023 (2 updates tracked since 2023).

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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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Daulton Grube reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cheyenne Regional Physicians Group, LLC

Same address

Medical Oncology

214 E 23RD ST
Cheyenne, WY 82001

Reassigned Medicare billing, Wyoming enrollment
116 clinicians in this Medicare group

NPI 1659458008 (307) 773-8237

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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)