Active NPI
Justin Sanders Groode, M.D.
- Family Medicine Physician
- Wellesley, MA
National Provider Identifier
1114108438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 243102
- Practice address
- 372 Washington St
Marino Center for Integrative Health
Wellesley, MA 02481-6202 - Phone
- (781) 235-5200
- Fax
- (617) 682-1101
- NPI assigned
- Nov 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 243102 | MA | Primary |
Addresses
Primary practice location
372 Washington St
Marino Center for Integrative Health
Wellesley, MA 02481-6202
Mailing address
372 Washington St
Wellesley, MA 02481-6202
Phone (781) 235-5200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M21670 | Other | MA | MEDICARE PROVIDER GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marino Foundation for Integrative Medicine, Inc. | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba The Marino Center for Integrative Health
- Psychologist
- Cambridge, MA
- NPI 1477662237
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314835200000",
"number": "1114108438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "372 WASHINGTON ST",
"city": "WELLESLEY",
"state": "MA",
"postal_code": "024816202",
"telephone_number": "781-235-5200",
"fax_number": "781-235-1103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "372 WASHINGTON ST",
"address_2": "MARINO CENTER FOR INTEGRATIVE HEALTH",
"city": "WELLESLEY",
"state": "MA",
"postal_code": "024816202",
"telephone_number": "781-235-5200",
"fax_number": "617-682-1101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROODE",
"first_name": "JUSTIN",
"middle_name": "SANDERS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-15",
"last_updated": "2011-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "243102",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER GROUP",
"identifier": "M21670",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wellesley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.