Individual provider Active NPI

John Patrick Grundy III, M.D.

  • Ophthalmology Physician
  • Laurel, MD
National Provider Identifier
1194775932
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D0052388 Issued in MD
Practice address
615 Main St
Laurel, MD 20707-4065
Phone
(301) 725-3010
Fax
(301) 725-3271
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D0052388 MD Primary

Addresses

Primary practice location

615 Main St
Laurel, MD 20707-4065

Mailing address

615 Main St
Laurel, MD 20707-4065
Phone (301) 725-3010

Other identifiers 2

IdentifierTypeStateIssuer
91930002OtherDCCAREFIRST DC
407806300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20061005000249 MD Practitioner - Ophthalmology 6305880154 Reassigns benefits to 1 organization
I20101130000483 DC Practitioner - Ophthalmology 6305880154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
State University of New York at Stony Brook, School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6011 University Blvd
Suite 190
Ellicott City, MD 21043-6104
Phone (301) 725-3010

615 Main St
Laurel, MD 20707-4065
Phone (301) 725-3010

Merit-based Incentive Payment System (MIPS)

Final score
78.37 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
27.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery307

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care and Surgical Center of Laurel PC CurrentSince Feb 9, 1998 Accepting new patients
Essential View Optical PastSince Feb 9, 1998 Accepting new patients

Locations

6011 University Blvd
Ste 190
Ellicott City, MD 21043
Phone (301) 604-2010

615 Main St
Laurel, MD 20707
Phone (301) 498-2003

300 Thomas Dr
Laurel, MD 20707
Phone (301) 725-3010

Organizations & group practices 2

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1194775932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074065",
            "telephone_number": "301-725-3010",
            "fax_number": "301-725-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074065",
            "telephone_number": "301-725-3010",
            "fax_number": "301-725-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNDY",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0052388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST DC",
            "identifier": "91930002",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407806300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.