Individual provider Active NPI

Michaela Leran Gruzensky

  • Internal Medicine Physician
  • Loma Linda, CA
National Provider Identifier
1184035743
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A145399 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-4074
NPI assigned
May 16, 2014
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A145399 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St # MC-1516
Loma Linda, CA 92350-1716
Phone (909) 558-4074

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250313003599 CA Practitioner - Internal Medicine 6204358765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Mar 16, 2025 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Mar 16, 2025 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
#1516
Loma Linda, CA 92350
Phone (909) 558-4884

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

11234 Anderson St
Ofc
Loma Linda, CA 92350
Phone (909) 558-4074

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

28078 Baxter Rd
Murrieta, CA 92563
Phone (760) 533-4541

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Interoperability endpoints

  • Direct secure messaging: mgruzensky24401@direct.llu.edu

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1184035743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST # MC-1516",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501716",
            "telephone_number": "909-558-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUZENSKY",
        "first_name": "MICHAELA",
        "middle_name": "LERAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A145399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.