THERESA GRIMES FNP-BC
NPI 1912910910
Nurse Practitioner - Family in Port Jefferson, NY
About Theresa Grimes Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THERESA GRIMES FNP-BC (NPI 1912910910) is an individual family provider in Port Jefferson, New York, licensed in New York (F332400-1) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Theresa Grimes Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Theresa Grimes reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Port Jefferson Station, NY 11777
- Reassigned Medicare billing, New York enrollment
- Also billed through NPI 1922486182 (New York)
- 232 clinicians in this Medicare group
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 2
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11777 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PORT JEFFERSON, NY 11777
PORT JEFFERSON, NY 11777
PORT JEFFERSON, NY 11777
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 Theresa Grimes's NPI number?
The NPI number for Theresa Grimes is 1912910910. It was assigned to this individual provider in the NPPES registry on August 14, 2006.
Where is Theresa Grimes located?
Theresa Grimes practices at 75 N Country Rd, Port Jefferson, NY 11777. The listed phone number is (631) 476-2847.
What is Theresa Grimes's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Theresa Grimes enrolled in Medicare?
Yes. Theresa Grimes is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Theresa Grimes's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Theresa Grimes reassigns Medicare benefits to John T. Mather Memorial Hospital (Port Jefferson Station, NY). The 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 Theresa Grimes's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Theresa Grimes was last updated on February 4, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Theresa Grimes, FNP-BC · NPI 1912910910
Family physician in Port Jefferson, New York. Individual provider, active in the CMS NPPES registry since August 14, 2006.
## Identity
- **NPI:** 1912910910 (Entity type: Individual)
- **Enumerated:** August 14, 2006
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** F332400-1 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 75 N COUNTRY RD, Port Jefferson, NY 11777-2119
- **Phone:** (631) 476-2847
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** John T. Mather Memorial Hospital (NPI 1376642371, Port Jefferson Station, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 4, 2011
- **Other identifiers:** Medicare ID-Type Unspecified 94N411 (NY); Medicaid 01993700 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1912910910) · Data from the CMS NPPES public registry.