Grigoriy A Rozenfeld, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OP61084938 Issued in WA

Practice address

4800 College St SE
Lacey, WA 98503-4389

Phone

(360) 486-2900

Fax

(360) 486-2901

NPI assigned

Mar 2, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, WA2 enrollments

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 2

Specialty

Emergency Medicine

Education

New York College of Osteo Medicine of New York Institute of Technology, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: grozenfeld1822039@wm.providencedirect.org

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.

• Providence Health & Services Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment Care Compare group NPD
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Temecula Valley Emergency Medical Associates

  • Specialist
  • Murrieta, CA
  • NPI 1407845092
  Medicare reassignment NPD
• Providence Health & Services Washington

  • General Practice Physician
  • Olympia, WA
  • NPI 1134656135
  NPD
• Cep America - California

  • Emergency Medicine Physician
  • Palm Springs, CA
  • NPI 1124073648
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1225060742
  NPD

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

• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997
  Care Compare affiliation

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1114167293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 COLLEGE ST SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985034389",
            "telephone_number": "360-486-2900",
            "fax_number": "360-486-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 COLLEGE ST SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985034389",
            "telephone_number": "360-486-2900",
            "fax_number": "360-486-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZENFELD",
        "first_name": "GRIGORIY",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-02",
        "last_updated": "2021-11-30",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP61084938",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A11107",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Rowlett
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• Royal Wa Lacey LLC
• Royal Wa Lacey LLC
• Jasiah Took Ruby-Schultz, CDA
• Ruddell Road Dental Center
• Jody Rudrud Grandorff
• Ronni Ruiz
• Colleen Rumsey

• Emergency Medicine Physician in Lacey, WA
• Providers in Lacey, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.