Individual provider Active NPI

Brian F Groden, MD

  • Pediatrics Physician
  • New Bedford, MA
National Provider Identifier
1215905443
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
71961 Issued in MA
Practice address
81 Hawthorn St # R
New Bedford, MA 02740-3429
Phone
(508) 961-2403
NPI assigned
Mar 14, 2006
Last updated
Dec 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 71961 MA Primary

Addresses

Primary practice location

81 Hawthorn St # R
New Bedford, MA 02740-3429

Mailing address

81 Hawthorn St # R
New Bedford, MA 02740-3429
Phone (508) 961-2403

Other identifiers 1

IdentifierTypeStateIssuer
3074013MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71961MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Bedford Medical Associates,PC Past Accepting new patients
Horizon Pediatrics Inc. Past Accepting new patients
Horizon Subspecialties Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bgroden7362@direct.chppoc.masshiway.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1215905443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HAWTHORN ST # R",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027403429",
            "telephone_number": "508-961-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HAWTHORN ST # R",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027403429",
            "telephone_number": "508-961-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODEN",
        "first_name": "BRIAN",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "71961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3074013",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.