Tabasco Family Practice PLLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

188450 Issued in NY

Legal business name

TABASCO FAMILY PRACTICE PLLC

Doing business as

tabasco health care

Practice address

5 Golden LN
Kerhonkson, NY 12446-1609

Phone

(845) 626-3424

Fax

(845) 626-4627

NPI assigned

Oct 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Lucinda Grovenburg, M.D.NPI 1275691180

Title

President

Phone

(845) 626-3424

Specialties & licenses 1

Addresses

Other names 1

• tabasco health care Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lucinda Grovenburg, MD

  • Addiction Medicine (Family Medicine) Physician
  • Kerhonkson, NY
  • NPI 1275691180
  Medicare reassignment Care Compare group NPD Authorized official
• James Grovenburg, MD

  • Addiction Medicine (Family Medicine) Physician
  • Kerhonkson, NY
  • NPI 1710022447
  Medicare reassignment Care Compare group NPD
• Cinnamon Rinzler, P.A.

  • Medical Physician Assistant
  • Woodstock, NY
  • NPI 1205938313
  Medicare reassignment

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1073701579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GOLDEN LN",
            "city": "KERHONKSON",
            "state": "NY",
            "postal_code": "124461609",
            "telephone_number": "845-626-3424",
            "fax_number": "845-626-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GOLDEN LN",
            "city": "KERHONKSON",
            "state": "NY",
            "postal_code": "124461609",
            "telephone_number": "845-626-3424",
            "fax_number": "845-626-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABASCO FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "GROVENBURG",
        "authorized_official_first_name": "LUCINDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-626-3424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NY",
            "license": "188450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "tabasco health care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adele L Schulz, RN
• Gail A. Sloat, RNWCC
• Rita J Stoddard, RN
• Mary Struber, LPN
• Soraya Sulaiman, RN
• Ulster Family Medicine, LLP
• Veritas Villa Inc
• Villa Veritas Foundation Inc.
• Tashena Williams Jones

• Addiction Medicine (Family Medicine) Physician in Kerhonkson, NY
• Providers in Kerhonkson, NY by specialty
• Addiction Medicine (Family Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.