Individual provider Active NPI

Ryan Groneman, DPT

  • Physical Therapist
  • Terre Haute, IN
National Provider Identifier
1053957845
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05013629A Issued in IN
Practice address
1400 E Pugh Dr Ste 28
Terre Haute, IN 47802-3938
Phone
(812) 232-1776
NPI assigned
Nov 27, 2019
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05013629A IN Primary

Addresses

Primary practice location

1400 E Pugh Dr Ste 28
Terre Haute, IN 47802-3938

Mailing address

62 Ridgecrest CT
Terre Haute, IN 47802-4974
Phone (801) 882-1590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200113001251 IN Practitioner - Physical Therapist in Private Practice 8224463617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independence Rehabilitation, Inc.Group PAC ID 2860596152, 3 clinicians

Practice addresses (Care Compare)

1400 E Pugh Dr
Suite 28
Terre Haute, IN 47802-3938
Phone (812) 232-1776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Rehabilitation, Inc. Physical Therapist CurrentSince Dec 8, 2019 Accepting new patients
Integrated Clinix Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients

Locations

1400 E Pugh Dr
Ste 28
Terre Haute, IN 47802
Phone (812) 232-1776

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1053957845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 RIDGECREST CT",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024974",
            "telephone_number": "801-882-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E PUGH DR STE 28",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478023938",
            "telephone_number": "812-232-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONEMAN",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-27",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013629A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.