Active NPI
Gregory Eckenrode, M.D.
- Surgical Critical Care Physician
- Norwalk, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Critical Care Physician
- License
- 1.071668
- Practice address
- 30 Stevens St Ste D
Norwalk, CT 06850-3859 - Phone
- (203) 852-2406
- Fax
- (203) 899-5281
- NPI assigned
- Apr 5, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Critical Care Physician | 2086S0102X | 288418 | NY | |
| Surgical Critical Care Physician | 2086S0102X | 25MA11052800 | NJ | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Surgical Critical Care Physician | 2086S0102X | 1.071668 | CT | Primary |
Addresses
Primary practice location
30 Stevens St Ste D
Norwalk, CT 06850-3859
Mailing address
30 Stevens St Ste D
Norwalk, CT 06850-3859
Phone (203) 852-2406
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255
3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone (914) 378-6148
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1.071668 | CT | MD | Surgical Critical Care Physician |
| 25MA11052800 | NJ | MD | Surgical Critical Care Physician |
| 288418 | NY | MD | Surgical Critical Care Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Medical Center | Past | Accepting new patients | |
| Montefiore Mount Vernon Hospital | Past | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
100 Corporate Dr
Ste 100
Yonkers, NY 10701
Phone (914) 378-6148
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- geckenrode@montefioredirect.com
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Bronx, NY
- NPI 1063525152
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
-
- Family Medicine Physician
- New York, NY
- NPI 1760288278
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1952476988
-
- General Acute Care Hospital
- Mount Vernon, NY
- NPI 1013345065
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1952476988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667174400000",
"number": "1003234048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 STEVENS ST STE D",
"city": "NORWALK",
"state": "CT",
"postal_code": "068503859",
"telephone_number": "203-852-2406",
"fax_number": "203-899-5281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 STEVENS ST STE D",
"city": "NORWALK",
"state": "CT",
"postal_code": "068503859",
"telephone_number": "203-852-2406",
"fax_number": "203-899-5281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKENRODE",
"first_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-05",
"last_updated": "2022-10-31",
"certification_date": "2022-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "NY",
"license": "288418",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "NJ",
"license": "25MA11052800",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "CT",
"license": "1.071668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norwalk, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.