Grisell Ramirez , FNP
Nurse Practitioner β’ Fresno, CA
6327 N Fresno St Ste 101
Fresno, CA 937105236
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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Grisell Ramirez is listed in NPPES under Nurse Practitioner.
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NPI assigned on October 18, 2012; this date does not establish years in practice.
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Published CMS data list 750 Medicare Part D prescriptions, including refills, in 2024.
Source: CMS, Medicare Part D Prescribers β by Provider and Drug, 2024. Published rows only; this is not a quality measure.
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Published Part D records, 2024:
- Prednisone β 122 prescription fills, including refills.
- Methotrexate (Methotrexate Sodium) β 114 prescription fills, including refills.
- Hydroxychloroquine Sulfate β 82 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers β by Provider and Drug, 2024. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See all 24 records in the table Β· Guide: How to read Medicare Part D prescriber data
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More Part D prescriptions than 60% of clinicians listed under Nurse Practitioner in Fresno, CA (2024, 81 clinicians with data). Median for this group: 518. Middle half: 76 to 1,238.
More Part D prescriptions than 70% of clinicians listed under Nurse Practitioner in California (2024, 3,221 clinicians with data). Median for this group: 248. Middle half: 63 to 852.
Source: CMS, Medicare Part D Prescribers β by Provider and Drug, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part D prescriptions went from 11 in 2020 to 750 in 2024.
Source: CMS, Medicare Part D Prescribers β by Provider and Drug, 2020β2024.
Practice Location & Contact Primary Location
6327 N Fresno St Ste 101
Fresno, CA 937105236
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
NPPES lists 1 additional practice-address record in Visalia, CA. See the list
Source: CMS NPPES NPI Registry, practice location records; release date unavailable.
CMS Doctors and Clinicians lists 1 group name: American Arthritis And Rheumatology Associates-Ca Pc. See the list
Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
Medicare Profile & Education
Source: CMS Doctors and Clinicians National Downloadable File
2012
What Public CMS Data Show
Nurse Practitioner: NPPES taxonomy is a reported classification, not proof of board certification.
30-day fills
921 standardized 30-day fills in 2024
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$427,381 in 2024
The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers β by Provider and Drug, 2024.
Open Payments general payments, program year 2025
All general payments: $2,178.92 across 108 records.
By nature of payment
- Food and Beverage: $2,178.92 across 108 records.
Reporting-company totals (3 largest of 13)
- ABBVIE INC.: $569.81 across 30 records.
- Amgen Inc.: $437.37 across 25 records.
- Janssen Pharmaceuticals, Inc: $286.22 across 11 records.
A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.
Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).
Years since graduation
14 years (graduated 2012)
CMS Doctors and Clinicians data list 2012 as the year this clinician finished professional school.
It tells you roughly how long ago the clinician finished school.
What this does not show: Years since graduation
It is not the number of years in practice, and more years does not mean better care.
Source: CMS Doctors and Clinicians National Downloadable File.
NPI first issued
2012
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Accepts Medicare assignment
CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.
With Original Medicare, you usually pay only your deductible and coinsurance, and the office sends the claim to Medicare for you.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, βDoes your provider accept Medicare as full payment?β
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Grisell Ramirez has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Grisell Ramirez as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Fresno and California
Billing and prescribing volume is not a quality rating.
Medicare Part D prescriptions
More Part D prescriptions than 60% of clinicians listed under Nurse Practitioner in Fresno, CA (2024, 81 clinicians with data). Median for this group: 518. Middle half: 76 to 1,238.
More Part D prescriptions than 70% of clinicians listed under Nurse Practitioner in California (2024, 3,221 clinicians with data). Median for this group: 248. Middle half: 63 to 852.
Part D drug cost
A higher Part D drug cost than 85% of clinicians listed under Nurse Practitioner in Fresno, CA (2024, 81 clinicians with data). Median for this group: $26,390. Middle half: $853 to $258,466.
A higher Part D drug cost than 90% of clinicians listed under Nurse Practitioner in California (2024, 3,221 clinicians with data). Median for this group: $13,982. Middle half: $995 to $121,041.
211 active clinicians are listed under Nurse Practitioner with a practice address in Fresno, CA (8,237 in California).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Fresno
10% of these 211 clinicians have the CMS telehealth indicator.
37.4% of these 211 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part D prescriptions
Medicare Part D prescriptions went from 11 in 2020 to 750 in 2024.
- 2020: 11
- 2021: 1,673
- 2022: 1,116
- 2023: 745
- 2024: 750
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30-day fills
30-day fills went from 15 in 2020 to 921 in 2024.
- 2020: 15
- 2021: 3,169
- 2022: 1,500
- 2023: 922
- 2024: 921
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Part D drug cost
Part D drug cost went from $80 in 2020 to $427,381 in 2024.
- 2020: $80
- 2021: $93,791
- 2022: $291,037
- 2023: $467,378
- 2024: $427,381
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Industry payments (Open Payments)
Industry payments (Open Payments) went from $424.50 in 2021 to $2,178.92 in 2025.
- 2021: $424.50
- 2022: $1,821.84
- 2023: $1,755.71
- 2024: $2,106.42
- 2025: $2,178.92
Sources: CMS Medicare Part D Prescribers (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo Β· Report an error.
Pharma & Medical Device Financial Disclosures
Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments
Program year 2025 (payments made January 1 β December 31, 2025): 108 records totaling $2,178.92.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| Janssen Pharmaceuticals, Inc |
Food and Beverage
In-kind items and services
|
TREMFYA | General | $146.21 |
| ABBVIE INC. |
Food and Beverage
In-kind items and services
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RINVOQ | General | $125.18 |
| UCB, Inc. |
Food and Beverage
In-kind items and services
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Bimzelx | General | $124.99 |
| Amgen Inc. |
Food and Beverage
In-kind items and services
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TAVNEOS | General | $97.52 |
| Janssen Pharmaceuticals, Inc |
Food and Beverage
In-kind items and services
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TREMFYA | General | $37.43 |
| ABBVIE INC. |
Food and Beverage
In-kind items and services
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RINVOQ | General | $34.96 |
| Novartis Pharmaceuticals Corporation |
Food and Beverage
In-kind items and services
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COSENTYX | General | $32.63 |
| ABBVIE INC. |
Food and Beverage
In-kind items and services
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SKYRIZI | General | $32.02 |
| ABBVIE INC. |
Food and Beverage
In-kind items and services
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SKYRIZI | General | $31.52 |
| GlaxoSmithKline, LLC. |
Food and Beverage
In-kind items and services
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BENLYSTA | General | $31.21 |
| Novartis Pharmaceuticals Corporation |
Food and Beverage
In-kind items and services
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COSENTYX | General | $30.88 |
| UCB, Inc. |
Food and Beverage
In-kind items and services
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Bimzelx | General | $30.75 |
| Novartis Pharmaceuticals Corporation |
Food and Beverage
In-kind items and services
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COSENTYX | General | $30.63 |
| Amgen Inc. |
Food and Beverage
In-kind items and services
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Otezla | General | $30.32 |
| Amgen Inc. |
Food and Beverage
In-kind items and services
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KRYSTEXXA | General | $29.79 |
| ABBVIE INC. |
Food and Beverage
In-kind items and services
|
RINVOQ | General | $28.89 |
| UCB, Inc. |
Food and Beverage
In-kind items and services
|
Bimzelx | General | $28.64 |
| ABBVIE INC. |
Food and Beverage
In-kind items and services
|
RINVOQ | General | $27.58 |
| Boehringer Ingelheim Pharmaceuticals, Inc. |
Food and Beverage
In-kind items and services
|
OFEV | General | $27.19 |
| ABBVIE INC. |
Food and Beverage
In-kind items and services
|
RINVOQ | General | $27.09 |
| ABBVIE INC. |
Food and Beverage
In-kind items and services
|
SKYRIZI | General | $26.47 |
| UCB, Inc. |
Food and Beverage
In-kind items and services
|
Bimzelx | General | $26.06 |
| ABBVIE INC. |
Food and Beverage
In-kind items and services
|
RINVOQ | General | $25.87 |
| Amgen Inc. |
Food and Beverage
In-kind items and services
|
EVENITY | General | $25.68 |
| ABBVIE INC. |
Food and Beverage
In-kind items and services
|
RINVOQ | General | $25.49 |
(top 25 shown)
Source: CMS Open Payments, program year 2025, released June 30, 2026.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2024.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Prednisone | Prednisone | 122 | 2,753 | $537.37 | 48 |
| Methotrexate | Methotrexate Sodium | 114 | 4,785 | $2,362.30 | 36 |
| Hydroxychloroquine Sulfate | Hydroxychloroquine Sulfate | 82 | 3,196 | $1,779.02 | 21 |
| Diclofenac Sodium | Diclofenac Sodium | 55 | 1,534 | $429.51 | 21 |
| Gabapentin | Gabapentin | 52 | 1,620 | $483.11 | 17 |
| Duloxetine Hcl | Duloxetine Hcl | 32 | 1,046 | $213.31 | β |
| Enbrel Sureclick | Etanercept | 25 | 728 | $187,139.56 | β |
| Leflunomide | Leflunomide | 23 | 1,116 | $969.72 | β |
| Pilocarpine Hcl | Pilocarpine Hcl | 22 | 780 | $810.14 | β |
| Hydrocodone-Acetaminophen | Hydrocodone/Acetaminophen | 20 | 577 | $485.13 | β |
| Alendronate Sodium | Alendronate Sodium | 19 | 1,036 | $136.86 | β |
| Humira(Cf) Pen | Adalimumab | 19 | 560 | $147,909.81 | β |
| Mycophenolate Mofetil | Mycophenolate Mofetil | 17 | 420 | $997.02 | β |
| Azathioprine | Azathioprine | 17 | 690 | $602.23 | β |
| Rasuvo | Methotrexate/Pf | 16 | 616 | $11,937.66 | β |
| Tramadol Hcl | Tramadol Hcl | 15 | 335 | $52.00 | β |
| Amlodipine Besylate | Amlodipine Besylate | 13 | 450 | $87.90 | β |
| Ibuprofen | Ibuprofen | 13 | 344 | $29.74 | β |
| Benlysta | Belimumab | 13 | 364 | $60,498.72 | β |
| Folic Acid | Folic Acid | 13 | 930 | $47.26 | β |
| Omeprazole | Omeprazole | 12 | 600 | $117.26 | β |
| Hydroxyzine Hcl | Hydroxyzine Hcl | 12 | 319 | $38.56 | β |
| Celecoxib | Celecoxib | 12 | 530 | $837.44 | β |
| Otrexup | Methotrexate/Pf | 12 | 336 | $8,879.53 | β |
Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2026-02-11NUCC Taxonomy Code: 363L00000X
(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.
NUCC Taxonomy Code: 363LA2200X
NUCC Taxonomy Code: 363LA2100X
NUCC Taxonomy Code: 363LF0000X
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - NURSE PRACTITIONER
I20181115001978
CA
3072819895
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Medicare Group Practice Enrollments
Source: CMS Doctors and Clinicians National Downloadable File
American Arthritis And Rheumatology Associates-Ca Pc
6327 N Fresno St, Fresno, CA 937105236
Phone: 5597329900
Secondary Practice Locations
5315 W Hillsdale Ave
Visalia, CA 932915118
Phone: 5597329900
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Nurse Practitioner - Family
Nurse Practitioner
Physician Assistant
Physician Assistant
Nurse Practitioner
Family Nurse Practitioner, Physician Assistant (Certified)
Nurse Practitioner
Family Nurse Practitioner
Nurse Practitioner
Family Nurse Practitioner (Certified)
Nurse Practitioner
Nurse Practitioner
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Nurse Practitioner (license number reported to NPPES: CA 22068)
Registered at 6327 N FRESNO ST STE 101, FRESNO, CA 937105236 (Tel: 5597329900)
Registered at 6327 N FRESNO ST STE 101, FRESNO, CA 937105236
Registered at 5339 N FRESNO ST STE 103, FRESNO, CA 937106851 (Tel: 5595003000)
Registered at 5339 N FRESNO ST STE 103, FRESNO, CA 937106851
Registered at 1350 S ORANGE AVE, FRESNO, CA 93702 (Tel: 5594575400)
Registered at 1350 S ORANGE AVE, FRESNO, CA 937023463
Registered at 4361 LATHAM ST STE 270, RIVERSIDE, CA 925014332 (Tel: 5592507368)
Nurse Practitioner (license number reported to NPPES: CA 22068)
Registered at 4361 LATHAM ST, RIVERSIDE, CA 925011730 (Tel: 5592507368)
Registered at 6955 W STUART AVE, FRESNO, CA 937234033 (Tel: 5592507368)
Nurse Practitioner (license number reported to NPPES: CA 22068)
Registered at 2823 FRESNO ST, FRESNO, CA 937211324 (Tel: 5594596000)
Registered at 2625 E DIVISADERO ST, FRESNO, CA 937211431 (Tel: 5594432682)
Nurse Practitioner (license number reported to NPPES: CA 22068)
NPI status registered as active in NPPES database
Registered at 1210 E ALMOND AVE, MADERA, CA 936375606 (Tel: 5596755530)
Registered at 2708 NATIONAL AVE, MADERA, CA 936374133 (Tel: 5599031789)
Recorded as GRISELL RAMIREZ, FNP
Nurse Practitioner (license number reported to NPPES: CA 22068)
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Nurse Practitioners in Fresno
- Erin Anderson, NP
- Courtney Moultrie, FNP
- Ha Hoang Nishihara, NP
- Wilmer Palacios Gonzalez, NP
- Lynda Francis, NP
- Lily Klug, FNP-C
Mailing Address
6327 N Fresno St Ste 101
Fresno, CA 937105236