Individual provider Active NPI

Laura Ann Gruneiro, M.D.

  • Vascular Surgery Physician
  • Port Charlotte, FL
National Provider Identifier
1295704252
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD421313 Issued in PA
Practice address
18316 Murdock Circle
Suite 107
Port Charlotte, FL 33948
Phone
(941) 627-6700
Fax
(941) 627-3300
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD421313 PA
Vascular Surgery Physician 2086S0129X MD421313 PA Primary

Addresses

Primary practice location

18316 Murdock Circle
Suite 107
Port Charlotte, FL 33948

Mailing address

18316 Murdock Circle
Suite 107
Port Charlotte, FL 33948
Phone (941) 627-6700

Other identifiers 1

IdentifierTypeStateIssuer
001958603MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080128000703 FL Practitioner - Vascular Surgery 2062305105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Icahn School of Medicine at Mount Sinai, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18316 Murdock Cir
Unit 107
Port Charlotte, FL 33948-1029
Phone (941) 627-6700

Hospital & facility affiliations

  • HCA Florida Fawcett Hospital Hospital, Port Charlotte, FL, CCN 100236

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD421313PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laura a Gruneiro MD PA Vascular Surgery CurrentSince Apr 15, 2010 Accepting new patients
Port Charlotte Hma Physician Management LLC Past Accepting new patients
Punta Gorda Hma Physician Management LLC Past Accepting new patients
Port Charlotte Hma Physician Management LLC Surgery Past Accepting new patients
Siu Physicians & Surgeons, Inc PastSince Aug 1, 2021 Accepting new patients

Locations

18316 Murdock Cir
Unit 107
Pt Charlotte, FL 33948
Phone (570) 620-7053

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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": "1330560000000",
    "number": "1295704252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18316 MURDOCK CIRCLE",
            "address_2": "SUITE 107",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33948",
            "telephone_number": "941-627-6700",
            "fax_number": "941-627-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18316 MURDOCK CIRCLE",
            "address_2": "SUITE 107",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33948",
            "telephone_number": "941-627-6700",
            "fax_number": "941-627-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNEIRO",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD421313",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD421313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001958603",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.