Active NPI
Terry Gruchow, PA-C
- Physician Assistant
- Tampa, FL
National Provider Identifier
1265524359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9102408
- Practice address
- 12902 Usf Magnolia Dr
Tampa, FL 33612-9416 - Phone
- (813) 745-3134
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9102408 | FL | Primary |
Addresses
Primary practice location
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Mailing address
PO Box 917770
Orlando, FL 32891-7770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, ME, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4055 Valley View LN
Suite 700
Dallas, TX 75244-4910
4055 Valley View LN
Suite 700
Dallas, TX 75244-5045
Merit-based Incentive Payment System (MIPS)
- Final score
- 88 of 100
- Quality
- 74.04
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.96
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9102408 | FL | MD | Physician Assistant |
Networks
- Freedom Health HMO Network
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": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200441600000",
"number": "1265524359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328917770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12902 USF MAGNOLIA DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336129416",
"telephone_number": "813-745-3134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUCHOW",
"first_name": "TERRY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2008-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9102408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.