Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jordania Grullon, PA-C

Individual provider Physician Assistant · NPI 1679298400

Jordania Grullon, PA-C is a Physician Assistant in Wilkes Barre, Pennsylvania. Qualified in 2022, 4 years ago. Practices with Northeast Gastroenterology Center, Inc, a 7-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
4
Licensed in
PA
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

175 S Wilkes Barre Blvd
Wilkes Barre, PA 18702-5040
Phone: (570) 208-6281
Fax: (570) 208-6282
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA064032 (PA)

Record details

NPI number1679298400
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 4, 2022
Last updated in NPPESJuly 17, 2025
Certification dateJuly 17, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Northeast Gastroenterology Center, Inc. — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Wilkes Barre