Individual provider Active NPI

David L. Groden, M.D.

  • Cardiovascular Disease Physician
  • Brookfield, WI
National Provider Identifier
1275575276
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
31054 Issued in WI
Practice address
16650 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5920
Phone
(262) 827-9200
Fax
(262) 827-9858
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 31054 WI Primary

Addresses

Primary practice location

16650 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5920

Mailing address

16650 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5920
Phone (262) 827-9200

Other identifiers 1

IdentifierTypeStateIssuer
31605700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20031112000245 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Infectious Disease 2365355732 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Apr 22, 2017 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Mar 15, 2009 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince May 6, 2010 Accepting new patients
Milwaukee Heart Specialists, S.C. Cardiovascular Disease Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Wisconsin Heart Group Associates LLC Cardiovascular Disease Past Accepting new patients
Wisconsin Heart Group Cardiovascular Disease Past Accepting new patients

Locations

16650 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 827-9200

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

16650 W Bluemound Rd
Ste 300
Brookfield, WI 53005

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

W180N8085 Town Hall Rd
Fl 3
Menomonee Falls, WI 53051

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

2025 W Oklahoma Ave
Ste 121
Milwaukee, WI 53215
Phone (414) 671-1711

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Organizations & group practices 8

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1275575276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16650 W BLUEMOUND RD",
            "address_2": "SUITE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055920",
            "telephone_number": "262-827-9200",
            "fax_number": "262-827-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16650 W BLUEMOUND RD",
            "address_2": "SUITE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055920",
            "telephone_number": "262-827-9200",
            "fax_number": "262-827-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODEN",
        "first_name": "DAVID",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "31054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31605700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.