Individual provider Active NPI

Matthew Groenwald, M.D.

  • Diagnostic Radiology Physician
  • Charlotte, NC
National Provider Identifier
1124461645
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2024-03688 Issued in NC
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

Updated by the provider on Jan 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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, AL2 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

Enrollment IDStateProvider typePAC IDDetails
I20190906000047 IL Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 6709169477 Reassigns benefits to 4 organizations
I20251230000465 AL Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 6709169477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
New York Medical College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mecklenburg Radiology Associates PA 95 clinicians
USA Health Physician Billing Services LLC 342 clinicians

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 Hospital, Charlotte, NC, CCN 340053
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Novant Health Rowan Medical Center Hospital, Salisbury, NC, CCN 340015
  • Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024-03688NCMDDiagnostic Radiology Physician
U4998TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Jul 29, 2019 Accepting new patients
Specialists in Medical Imaging, SC Diagnostic Radiology CurrentSince Jul 18, 2022 Accepting new patients
RMH Pathologists, LTD Current Accepting new patients
Rockford Health Physicians CurrentSince Jul 29, 2019 Accepting new patients
Mecklenburg Radiology Associates, P.a. Diagnostic Radiology CurrentSince Jan 27, 2025 Accepting new patients
USA Health Physician Billing Services LLC Diagnostic Radiology CurrentSince Dec 1, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince Jul 29, 2019 Accepting new patients
USA Health Physician Billing Services LLC Diagnostic Radiology CurrentSince Dec 1, 2025 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.

Hospital & facility affiliations 8

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": "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

Verify at the official NPI Registry.