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MAGGIE J GROMMON APNP. FNP-BC
NPI 1831866367
Nurse Practitioner in Madison, WI

Active since August 24, 2021PECOS EnrolledAccepts Medicare Assignment
752 N HIGH POINT RD, MADISON, WI 53717(608) 824-4000(608) 824-4917 Get Directions Write a Review

NPPES record last updated: August 19, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 19, 2022, Aug 24, 2021 (2 updates tracked since 2021).

About Maggie J Grommon Apnp. Fnp-bc NPPES

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

MAGGIE J GROMMON APNP. FNP-BC (NPI 1831866367) is an individual nurse practitioner in Madison, Wisconsin, licensed in Wisconsin (11244-33) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital - Madison, and maintains a secondary practice location in Madison.

NPPES Registry Identity

NPI1831866367
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMAGGIE J GROMMONCredential: APNP. FNP-BC
Location Address752 N HIGH POINT RDMadison, WI 53717-2236
Mailing Address752 N High Point RdMadison, WI 53717-2236 · (608) 824-4000 · Fax (608) 824-4917
Phone(608) 824-4000
Fax(608) 824-4917
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateAugust 24, 2021
Last NPPES UpdateAugust 19, 20222 updates tracked since enumeration
NPPES CertifiedAugust 18, 2022
✔ NPI 1831866367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in WI · 11244-33
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 11244-33 (WI)
752 N HIGH POINT RD, Madison, WI 53717
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Secondary Practice Location 1

Location 11617 Sherman AveMadison, WI 53704-5930 · Phone (680) 245-3094

Other Identifiers 1

Medicaid1831866367WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Dean Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Maggie J Grommon Apnp. Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567852668
PECOS Enrollment IDI20211203001785
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 Reassignments

2

Medicare enrollment records show Maggie Grommon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pivotal Health, Inc.
2.1 mi
Family Medicine
3030 LAURA LN STE 130
Middleton, WI 53562
  • Reassigned Medicare billing, Wisconsin enrollment
  • 16 clinicians in this Medicare group
NPI 1508465220 (888) 688-4746
Dean Health Systems, Inc
6.3 mi
Allergy & Immunology
1211 FISH HATCHERY RD
Madison, WI 53715
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,377 clinicians in this Medicare group
NPI 1053358846 (608) 252-8000

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

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
85 services68 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
68 services56 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
49 services43 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
49 services49 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
22 services20 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test 85027
A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.
18 services18 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ssm Health St Mary's Hospital - Madison

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520083
Location700 South Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53717 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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 20

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

HEATHER L MUCKLER COTA
Occupational Therapy Assistant
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4821
DR. MINDY BAUER PHARMD
Pharmacist
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4500
DAVID K FALK MD
Dermatology
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DAVID A SORBER MD
Internal Medicine
752 N HIGH POINT RD, DEAN MEDICAL CENTER
MADISON, WI 53717
Dane County (608) 824-4800
JULIA L. THORSEN M.D.
Allergy & Immunology
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
SARAH A OLIVER PA-C
Physician Assistant
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DR. GRANT MACAULAY M.D.
Internal Medicine
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DR. JUI B HAKER MD
Preventive Medicine (Occupational Medicine)
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000

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 Maggie Grommon's NPI number?

The NPI number for Maggie Grommon is 1831866367. It was assigned to this individual provider in the NPPES registry on August 24, 2021.

Where is Maggie Grommon located?

Maggie Grommon practices at 752 N High Point Rd, Madison, WI 53717. The listed phone number is (608) 824-4000.

What is Maggie Grommon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Maggie Grommon enrolled in Medicare?

Yes. Maggie Grommon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Maggie Grommon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Maggie Grommon reassigns Medicare benefits to 2 organizations: Pivotal Health, Inc. (Middleton, WI) and Dean Health Systems, Inc (Madison, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Maggie Grommon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Maggie Grommon accept?

Health plans from Anthem Blue Cross and Blue Shield and Dean Health Plan list Maggie Grommon 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.

Is Maggie Grommon affiliated with any hospitals?

According to CMS data, Maggie Grommon is affiliated with Ssm Health St Mary's Hospital - Madison.

When was this NPI record last updated?

The NPPES record for Maggie Grommon was last updated on August 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.