NPIMap

Individual provider Active NPI

Judah Kenneth Gruen, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1013366962
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T6578 Issued in TX
Practice address
5959 Harry Hines Blvd
Dallas, TX 75235-6234
Phone
(214) 645-1700
NPI assigned
Jun 10, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 83266 GA
Internal Medicine Physician 207R00000X 2016019452 MO
Internal Medicine Physician 207R00000X T6578 TX Primary

Addresses

Primary practice location

5959 Harry Hines Blvd
Dallas, TX 75235-6234

Mailing address

49 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3049
Phone (404) 778-1606

Other names 1

  • Kenneth Michael Gruen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220811003939 TX Practitioner - Internal Medicine 1153697131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

5939 Harry Hines Blvd
Dallas, TX 75235-6246
Phone (214) 645-0624

Hospital & facility affiliations

  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044
  • Parkland Health & Hospital System Hospital, Dallas, TX, CCN 450015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
83266GAMDInternal Medicine Physician
2016019452MOMDInternal Medicine Physician
T6578TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 1, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 1, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Internal Medicine Past Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

5939 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 645-1919

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

5959 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 630-5191

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: judah.gruen.1@18564.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 46

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 46

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1013366962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033049",
            "telephone_number": "404-778-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752356234",
            "telephone_number": "214-645-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUEN",
        "first_name": "JUDAH",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-10",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "83266",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2016019452",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T6578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNETH",
            "last_name": "GRUEN",
            "middle_name": "MICHAEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.