Active NPI
Matthew Groenwald, M.D.
- Diagnostic Radiology Physician
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 2024-03688
- Practice address
- 3623 Latrobe Dr Ste 216
Charlotte, NC 28211-2117 - Phone
- (704) 332-1291
- Fax
- (704) 926-1832
- NPI assigned
- Apr 15, 2013
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | U4998 | TX | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 036149623 | IL | |
| Diagnostic Radiology Physician | 2085R0202X | 2024-03688 | NC | Primary |
Addresses
Primary practice location
3623 Latrobe Dr Ste 216
Charlotte, NC 28211-2117
Mailing address
PO Box 221249
Charlotte, NC 28222-1249
Phone (704) 332-1291
Other practice location 1
2400 N Rockton Ave
Rockford, IL 61103-3655
Phone (815) 971-5000
Other practice location 2
5 Perryridge Rd
Greenwich, CT 06830-4608
Phone (203) 863-3911
Other practice location 3
700 E Marshall Ave
Longview, TX 75601-5580
Phone (903) 315-1488
Other practice location 4
4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone (815) 334-5566
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190906000047 | IL | Practitioner - Interventional Radiology | 6709169477 | Reassigns benefits to 4 organizations |
| I20251230000465 | AL | Practitioner - Interventional Radiology | 6709169477 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Radiology
- Education
- New York Medical College, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mecklenburg Radiology Associates PAUSA Health Physician Billing Services LLC
Practice addresses (Care Compare)
11320 Aberdeen Rd
Belvidere, IL 61008-8701
Phone (704) 332-1291
2451 University Hospital Dr
Mobile, AL 36617-2300
Phone (251) 471-7000
440 Glencrest Dr
Inverness, IL 60010-5636
Phone (704) 332-1291
75 S University Blvd
Unit 6000
Mobile, AL 36608-3274
Phone (251) 660-5555
Hospital & facility affiliations
- Novant Health Presbyterian Medical Center
- Novant Health Matthews Medical Center
- Novant Health Huntersville Medical Center
- Novant Health Rowan Medical Center
- Novant Health Ballantyne Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024-03688 | NC | MD | Diagnostic Radiology Physician |
| U4998 | TX | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health System Corporation | Current | Accepting new patients | |
| Specialists in Medical Imaging, SC | Diagnostic Radiology | Current | Accepting new patients |
| RMH Pathologists, LTD | Current | Accepting new patients | |
| Rockford Health Physicians | Current | Accepting new patients | |
| Mecklenburg Radiology Associates, P.a. | Diagnostic Radiology | Current | Accepting new patients |
| USA Health Physician Billing Services LLC | Diagnostic Radiology | Current | Accepting new patients |
| Mercy Health System Corporation | Current | Accepting new patients | |
| USA Health Physician Billing Services LLC | Diagnostic Radiology | Current | Accepting new patients |
Locations
75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555
75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
348 S Division St
Harvard, IL 60033
Phone (815) 943-1122
901 Grant St
Harvard, IL 60033
Phone (815) 943-5431
4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100
600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310
3623 Latrobe Dr
Ste 216
Charlotte, NC 28211
Phone (704) 926-1827
Organizations & group practices 11
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.
-
- Diagnostic Radiology Physician
- Charlotte, NC
- NPI 1295790657
Diagnostic Radiology, IL
-
- Internal Medicine Physician
- Mobile, AL
- NPI 1720645468
AL, Diagnostic Radiology
-
- Diagnostic Radiology Physician
- Olympia Fields, IL
- NPI 1841687951
Diagnostic Radiology, IL
-
- Durable Medical Equipment & Medical Supplies
- Mobile, AL
- NPI 1750949913
-
- Radiation Oncology Physician
- Mobile, AL
- NPI 1871150508
-
- Land Ambulance
- Mobile, AL
- NPI 1992356364
-
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
-
- Anatomic Pathology Physician
- Rockford, IL
- NPI 1184671992
-
- Diagnostic Radiology Physician
- Mobile, AL
- NPI 1609434067
Diagnostic Radiology
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1740998020
Hospital
-
- General Acute Care Hospital
- Matthews, NC
- NPI 1063463156
Hospital
-
- General Acute Care Hospital
- Salisbury, NC
- NPI 1508843566
Hospital
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Charlotte, NC
- NPI 1396798591
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737331200000",
"number": "1124461645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 221249",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282221249",
"telephone_number": "704-332-1291",
"fax_number": "704-926-1832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3623 LATROBE DR STE 216",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282112117",
"telephone_number": "704-332-1291",
"fax_number": "704-926-1832"
}
],
"practiceLocations": [
{
"address_1": "2400 N Rockton Ave",
"address_purpose": "LOCATION",
"city": "Rockford",
"state": "IL",
"postal_code": "611033655",
"country_code": "US",
"telephone_number": "815-971-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5 Perryridge Rd",
"address_purpose": "LOCATION",
"city": "Greenwich",
"state": "CT",
"postal_code": "068304608",
"country_code": "US",
"telephone_number": "203-863-3911",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "700 E Marshall Ave",
"address_purpose": "LOCATION",
"city": "Longview",
"state": "TX",
"postal_code": "756015580",
"country_code": "US",
"telephone_number": "903-315-1488",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4201 W Medical Center Dr",
"address_purpose": "LOCATION",
"city": "McHenry",
"state": "IL",
"postal_code": "600508409",
"country_code": "US",
"telephone_number": "815-334-5566",
"fax_number": "815-759-4008",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GROENWALD",
"first_name": "MATTHEW",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-15",
"last_updated": "2025-01-20",
"certification_date": "2025-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "U4998",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "IL",
"license": "036149623",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NC",
"license": "2024-03688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.