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

Kylie Jo Grogan, PA-C

Individual provider Physician Assistant · NPI 1629708532

Kylie Jo Grogan, PA-C is a Physician Assistant in Grand Forks, North Dakota. Qualified in 2022, 4 years ago. Practices with Altru Health System, a 667-clinician group and accepts Medicare assignment. Licensed in North Dakota.

Years since qualifying
4
Licensed in
ND
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

4440 S Washington St
Grand Forks, ND 58201-7245
Phone: (701) 732-7700
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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 PAC0954 (ND)

Record details

NPI number1629708532
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 14, 2022
Last updated in NPPESNovember 20, 2023
Certification dateNovember 20, 2023

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 Altru Health System — 667 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Grand Forks