Individual provider Active NPI

Michael H Grodin, D.O.

  • Ophthalmology Physician
  • Lutherville, MD
National Provider Identifier
1184670366
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
H0062012 Issued in MD
Practice address
1209 York Rd
Suite 200
Lutherville, MD 21093-6220
Phone
(410) 821-9490
Fax
(410) 821-9495
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X H0062012 MD Primary
Ophthalmology Physician 207W00000X 0102201638 VA
Ophthalmology Physician 207W00000X DO034176 DC
Ophthalmology Physician 207W00000X 25MB08472300 NJ

Addresses

Primary practice location

1209 York Rd
Suite 200
Lutherville, MD 21093-6220

Mailing address

1209 York Rd
Suite 200
Lutherville, MD 21093-6220
Phone (410) 821-9490

Other identifiers 2

IdentifierTypeStateIssuer
405458000MedicaidMD
143192VYZOtherMDMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20040820000476 MD Practitioner - Ophthalmology 1355334780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Katzen Medical Associates PCGroup PAC ID 9436051232, 24 clinicians

Practice addresses (Care Compare)

1209 York Rd
Lutherville, MD 21093-6220
Phone (410) 821-9490

Merit-based Incentive Payment System (MIPS)

Final score
85.29 of 100Reported as group
Quality
82.7
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO034176DCMDOphthalmology Physician
0102201638VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Katzen Medical Associates, PC Ophthalmology CurrentSince Jun 17, 2005 Accepting new patients
Retina Institute of Virginia PLLC Ophthalmology Past Accepting new patients
Monmouth Retina Consultants, P.a. Ophthalmology Past Accepting new patients
Bert M. Glaser National Retina Institute, LLC Ophthalmology Past Accepting new patients
Access Eye Centers, Inc. Ophthalmology Past Accepting new patients

Locations

3401 Box Hll Corp Center Dr
Ste 202
Abingdon, MD 21009
Phone (410) 569-0707

301 Saint Paul St
Ste 902
Baltimore, MD 21202
Phone (410) 727-8380

1209 York Rd
Ste 200
Lutherville Timonium, MD 21093
Phone (410) 821-9490

7106 Ridge Rd
Rosedale, MD 21237
Phone (410) 687-2300

1209 York Rd
Timonium, MD 21093
Phone (410) 821-9490

901 Dulaney Valley Rd
Ste 200
Towson, MD 21204
Phone (410) 337-4500

Interoperability endpoints

  • Direct secure messaging: michael.grodin.p1@direct.nri.nextgenshare.com
  • Direct secure messaging: michael.grodin.p1@direct.katzeneye.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://app.meldrx.com/api/fhir/mi-riv

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1184670366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 YORK RD",
            "address_2": "SUITE 200",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936220",
            "telephone_number": "410-821-9490",
            "fax_number": "410-821-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 YORK RD",
            "address_2": "SUITE 200",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936220",
            "telephone_number": "410-821-9490",
            "fax_number": "410-821-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODIN",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "H0062012",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0102201638",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "DC",
            "license": "DO034176",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MB08472300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405458000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "143192VYZ",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

Verify at the official NPI Registry.