Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jack W Grinnan, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1487090288

Jack W Grinnan, MD is an Urology in Mesa, Arizona. Graduated from University of Texas Medical School at San Antonio in 2013, 13 years ago. Practices with Arizona Urology Specialists PLLC, a 83-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
13
Trained at
University of Texas Medical School at San Antonio
Licensed in
AZ
In the registry since
2013
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2530 E Southern Ave
Mesa, AZ 85204-5411
Phone: (480) 834-4188
Fax: (480) 834-6181
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 263 Farmington Ave, Farmington, CT 06032-1956 — (860) 679-2147

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 55776 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1487090288
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 20, 2013
Last updated in NPPESMarch 21, 2025
Certification dateMarch 21, 2025
Mailing address10200 Grand Central Ave Ste 220, Owings Mills, MD 21117-4366

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolUNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Graduated 2013 (13 years in practice)
Group practice Arizona Urology Specialists Pllc — 83 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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