Matthew B Grundfast, D.O.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

052944 Issued in GA

Practice address

111 Fairview Park Dr
Dublin, GA 31021-2501

Phone

(478) 277-1929

Fax

(478) 304-1468

NPI assigned

Aug 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

GastroenterologyAlso: Internal Medicine

Education

New York Medical College, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Archbold Medical Group, Inc. 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Archbold Memorial Hospital Hospital, Thomasville, GA, CCN 110038

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.grundfast@srpcc.gadirect.net
• Direct secure messaging: drmatthewgrundfast@mah150.powersoftmdsecure.com

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.

• Archbold Medical Group, Inc.

  • Surgery Physician
  • Thomasville, GA
  • NPI 1831353036

  GA

  Medicare reassignment Care Compare group NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464

  GA

  Medicare reassignment NPD
• Archbold Medical Group, Inc.

  • Pulmonary Disease Physician
  • Thomasville, GA
  • NPI 1972097293
  NPD
• Phoebe Orthopedic Specialists

  • Clinic/Center
  • Albany, GA
  • NPI 1871891127
  NPD
• Southeast Regional Primary Care Corporation

  • Multi-Specialty Clinic/Center
  • Vidalia, GA
  • NPI 1467568907
  NPD
• Tift Regional Health System Inc

  • Medical Oncology Physician
  • Tifton, GA
  • NPI 1306158480
  NPD
• Tift Regional Health System Inc

  • Ophthalmology Physician
  • Tifton, GA
  • NPI 1790280857
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• John D Archbold Memorial Hospital Inc

  • General Acute Care Hospital
  • Thomasville, GA
  • NPI 1194779702

  Hospital

  Care Compare affiliation
• John D. Archbold Memorial Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Thomasville, GA
  • NPI 1104867738

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1124011085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E WESTERLEE DR",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317635817",
            "telephone_number": "229-886-5150",
            "fax_number": "682-200-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FAIRVIEW PARK DR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212501",
            "telephone_number": "478-277-1929",
            "fax_number": "478-304-1468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2740 Ray Knight Way Ste 100",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "GA",
            "postal_code": "317070226",
            "country_code": "US",
            "telephone_number": "229-312-0698",
            "fax_number": "229-438-7898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Fairview Park Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "GA",
            "postal_code": "310212565",
            "country_code": "US",
            "telephone_number": "478-277-1255",
            "fax_number": "478-304-1467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUNDFAST",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "052944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Tripp Griffin, PHARMD
• Gary S Griffin, MD
• Le Roy Langly Griffin Jr., MSW
• Tina Michelle Griffin
• Joy Griswold, RN
• Natalie Rodziewicz Guinn, M.D.
• Melanie Gunn, LCSW
• Amber Guyton, CNM
• Monica Guyton, NP-C
• Angela J. Hackle, LPN

• All providers in Dublin, GA
• Gastroenterology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.