NPIMap

Individual provider Active NPI

Kenneth M Grundfast, M.D.

  • Otolaryngology Physician
  • Boston, MA
National Provider Identifier
1336101054
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
160725 Issued in MA
Practice address
830 Harrison Ave
Ste 1400
Boston, MA 02118
Phone
(617) 638-8124
Fax
(617) 414-4953
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD6119 DC
Otolaryngology Physician 207Y00000X 160725 MA Primary

Addresses

Primary practice location

830 Harrison Ave
Ste 1400
Boston, MA 02118

Mailing address

960 Massachussetts Avenue
FL 2
Boston, MA 02118-2690

Other practice location 1

800 Huntington Ave
Boston, MA 02115-6303
Phone (617) 936-6160

Other practice location 2

2300 M St NW
Washington, DC 20037-1434
Phone (202) 741-3574

Other practice location 3

243 Charles St
Boston, MA 02114-3002
Phone (617) 573-5526

Other identifiers 2

IdentifierTypeStateIssuer
110061841AMedicaidMA
3115087MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110620000229 MA Practitioner - Otolaryngology 0446259725 Reassigns benefits to 3 organizations
I20231130003496 DC Practitioner - Otolaryngology 0446259725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
State University of Ny Upstate Medical University, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New England Ear Nose and Throat LLCGroup PAC ID 7618125931, 11 clinicians
Medical Faculty Associates, IncGroup PAC ID 4082528898, 676 clinicians
Bumc Otolaryngologic Foundation IncGroup PAC ID 2163409400, 28 clinicians

Practice addresses (Care Compare)

2000 Washington St
Mob White 544
Newton, MA 02462-1646
Phone (617) 910-0368

2300 M St NW
Washington, DC 20037-1434
Phone (202) 677-6990

243 Charles St
Boston, MA 02114-3002
Phone (617) 523-7900

830 Harrison Ave
Suite 1400
Boston, MA 02118-2905
Phone (617) 638-8124

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD6119DCMDOtolaryngology Physician
160725MAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New England Ear Nose and Throat LLC Otolaryngology CurrentSince Jan 1, 2023 Accepting new patients
Medical Faculty Associates, Inc Otolaryngology CurrentSince Nov 16, 2023 Accepting new patients
Massachusetts Eye and Ear Associates, Inc. Otolaryngology CurrentSince Jul 1, 2017 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Massachusetts Eye and Ear Infirmary Current Accepting new patients
Bumc Otolaryngologic Foundation, Inc. Otolaryngology CurrentSince Aug 11, 1999 Accepting new patients

Locations

2300 M St NW
Washington, DC 20037
Phone (202) 741-2222

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

960 Massachusetts Ave
Ste 2
Boston, MA 02118

243 Charles St
Boston, MA 02114
Phone (617) 523-7900

800 Huntington Ave
Boston, MA 02115
Phone (617) 525-9544

2000 Washington St
Ste 544
Newton Lower Falls, MA 02462
Phone (617) 910-0368

Interoperability endpoints

  • Direct secure messaging: grundfast.kenneth.meei@direct.partners.masshiway.net
  • Direct secure messaging: kgrundfast10484@direct.bmc.masshiway.net

Organizations & group practices 6

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 9

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1336101054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVE",
            "address_2": "STE 1400",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-8124",
            "fax_number": "617-414-4953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Huntington Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156303",
            "country_code": "US",
            "telephone_number": "617-936-6160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 M St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200371434",
            "country_code": "US",
            "telephone_number": "202-741-3574",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "243 Charles St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021143002",
            "country_code": "US",
            "telephone_number": "617-573-5526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUNDFAST",
        "first_name": "KENNETH",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "DC",
            "license": "MD6119",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "160725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110061841A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3115087",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.