Individual provider Active NPI

Christian James Gronbeck, MD

  • Dermatology Physician
  • Beverly, MA
National Provider Identifier
1093392797
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
1026512 Issued in MA
Practice address
85 Herrick St
Beverly, MA 01915-1790
Phone
(978) 922-3000
Fax
(978) 524-7954
NPI assigned
Mar 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 1026512 MA Primary

Addresses

Primary practice location

85 Herrick St
Beverly, MA 01915-1790

Mailing address

PO Box 24300
New York, NY 10087-4300
Phone (781) 744-8771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Connecticut School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

41 Mall Rd
Burlington, MA 01805-0001

701 Edgewater Drive
Suite 430
Wakefield, MA 01880-6236

PO Box
New York, NY 10087

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1616803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1093392797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24300",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100874300",
            "telephone_number": "781-744-8771",
            "fax_number": "978-524-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790",
            "telephone_number": "978-922-3000",
            "fax_number": "978-524-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONBECK",
        "first_name": "CHRISTIAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-27",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "1026512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.