Kenneth Grudko, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

G80633 Issued in CA

Practice address

10666 N Torrey Pines Rd
La Jolla, CA 92037-1027

Phone

(858) 554-8860

NPI assigned

Sep 22, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
• Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgrudko7929@scrippshlth.medalliesdirect.net

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.

• Scripps Health

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072

  CA

  Medicare reassignment Care Compare group NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Health

  • Home Health Agency
  • San Diego, CA
  • NPI 1578556114
  NPD
• Scripps Health

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • La Jolla, CA
  • NPI 1619108503
  NPD
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  NPD
• Scripps Health

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1881636108
  NPD
• Scripps Clinic Medical Group

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1124003280
  NPD (past)
• Scripps Clinic Medical Group, Inc

  • Radiation Oncology Physician
  • San Diego, CA
  • NPI 1073853180
  NPD (past)

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

• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841233780

  Hospital

  Care Compare affiliation
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1164522199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54433 FILE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10666 N TORREY PINES RD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371027",
            "telephone_number": "858-554-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUDKO",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G80633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G806330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tomas M Grippo, M.D.
• Griselda Gonzalez Granados
• Bruce Emil Grizer, RNFA
• Erin Andrea Gross, M.D.
• Ian R Grover, MD
• Brandon Larren Grusd, M.D., J.D.
• Joseph Leonard Grzeskiewicz, M.D.
• Guarneri Integrative Health, Inc.
• Erminia M. Guarneri, M.D.
• John Guatelli, M.D.

• All providers in La Jolla, CA
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.