Individual provider Active NPI

Martin J Gruenberg, DO

  • Occupational Medicine Physician
  • Mesa, AZ
National Provider Identifier
1326139247
Registry record updated Apr 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
4496 Issued in AZ
Practice address
2550 N Thunderbird Cir
Suite 303
Mesa, AZ 85215-1214
Phone
(480) 776-1603
Fax
(480) 455-4940
NPI assigned
Sep 27, 2006
Last updated
Apr 5, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB05665000 NJ
Family Medicine Physician 207Q00000X 25MB05665000 NJ
Occupational Medicine Physician 2083X0100X 4496 AZ Primary

Addresses

Primary practice location

2550 N Thunderbird Cir
Suite 303
Mesa, AZ 85215-1214

Mailing address

2550 N Thunderbird Cir
Suite 303
Mesa, AZ 85215-1214
Phone (480) 776-1603

Other identifiers 1

IdentifierTypeStateIssuer
8486905MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20081126000327 AZ Practitioner - Preventive MedicinePractitioner - General PracticePractitioner - Osteopathic Manipulative Medicine 7113975988 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nextcare Arizona I JV LLC Past Accepting new patients
Emurgent Care PLLC Past Accepting new patients

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365120000000",
    "number": "1326139247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 N THUNDERBIRD CIR",
            "address_2": "SUITE 303",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151214",
            "telephone_number": "480-776-1603",
            "fax_number": "480-455-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 N THUNDERBIRD CIR",
            "address_2": "SUITE 303",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151214",
            "telephone_number": "480-776-1603",
            "fax_number": "480-455-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUENBERG",
        "first_name": "MARTIN",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2013-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB05665000",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB05665000",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "AZ",
            "license": "4496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8486905",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.