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MARY E GRANDON PA-C
NPI 1790754638
Physician Assistant in Clendenin, WV

Active since March 14, 2006PECOS Enrolled
107 KOONTZ AVE. STE. 200, CLENDENIN, WV 25045(304) 548-7272(304) 548-7149 Get Directions Write a Review

NPPES record last updated: May 21, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary E Grandon Pa-c NPPES

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

MARY E GRANDON PA-C (NPI 1790754638) is an individual physician assistant in Clendenin, West Virginia, licensed in West Virginia (00616) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790754638
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMARY E GRANDONCredential: PA-C
Location Address107 KOONTZ AVE. STE. 200Clendenin, WV 25045
Mailing AddressPo Box 70Dawes, WV 25054 · (304) 734-2040 · Fax (304) 734-2047
Phone(304) 548-7272
Fax(304) 548-7149
Sole ProprietorNo
Enumeration DateMarch 14, 2006
Last NPPES UpdateMay 21, 2020
NPPES CertifiedMay 21, 2020
✔ NPI 1790754638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WV · 00616
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
107 KOONTZ AVE. STE. 200, Clendenin, WV 25045
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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)

Mary E Grandon Pa-c 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25045 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
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Mary Grandon's NPI number?

The NPI number for Mary Grandon is 1790754638. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Where is Mary Grandon located?

Mary Grandon practices at 107 Koontz Ave. Ste. 200, Clendenin, WV 25045. The listed phone number is (304) 548-7272.

What is Mary Grandon's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mary Grandon enrolled in Medicare?

Yes. Mary Grandon is registered in the Medicare PECOS enrollment system.

What insurance does Mary Grandon accept?

Health plans from CareSource list Mary Grandon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Grandon was last updated on May 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.