Individual provider Active NPI

Edward D Grom, MD

  • Emergency Medicine Physician
  • San Francisco, CA
National Provider Identifier
1104357169
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
159915 Issued in CA
Practice address
UCSF Medical Center, 505 Parnassus Ave
M-24, Campus Box 0203
San Francisco, CA 94143
Phone
(415) 353-1539
NPI assigned
Mar 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 159915 CA Primary

Addresses

Primary practice location

UCSF Medical Center, 505 Parnassus Ave
M-24, Campus Box 0203
San Francisco, CA 94143

Mailing address

UCSF Medical Center, 505 Parnassus Ave
M-24, Campus Box 0203
San Francisco, CA 94143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210305000920 CA Practitioner - Emergency Medicine 1658787254 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Harvard Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone (415) 925-7000

Hospital & facility affiliations

  • Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360

Merit-based Incentive Payment System (MIPS)

Final score
84.89 of 100Reported as group
Quality
81.13
Improvement activities
40
Cost
71.5

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
159915CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Current Accepting new patients
University of California San Francisco CurrentSince Jul 29, 2021 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Mar 2, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 29, 2021 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 29, 2021 Accepting new patients
University of California San Francisco CurrentSince Jul 29, 2021 Accepting new patients
San Francisco Emergency Medical Associates Emergency Medicine CurrentSince Jul 15, 2021 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Mar 2, 2021 Accepting new patients

Locations

250 Bon Air Rd
Kentfield, CA 94904
Phone (415) 464-1350

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

3360 Geary Blvd
Ste 201
San Francisco, CA 94118
Phone (415) 353-3100

505 Parnassus Ave
#M24
San Francisco, CA 94143
Phone (415) 353-1529

45 Castro St
San Francisco, CA 94114
Phone (415) 241-5695

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

30 Mark West Springs Rd
Santa Rosa, CA 95403
Phone (707) 576-4000

Interoperability endpoints

  • Direct secure messaging: egrom86661@direct-ucsfmedicalcenter.org

Organizations & group practices 9

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1104357169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UCSF MEDICAL CENTER, 505 PARNASSUS AVE",
            "address_2": "M-24, CAMPUS BOX 0203",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCSF MEDICAL CENTER, 505 PARNASSUS AVE",
            "address_2": "M-24, CAMPUS BOX 0203",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94143",
            "telephone_number": "415-353-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROM",
        "first_name": "EDWARD",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "159915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.