Sarah Clark Grudberg, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

215947 Issued in MA

Practice address

1400 VFW Pkwy
Medical Service 111
West Roxbury, MA 02132-4927

Phone

(857) 203-5907

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407967466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BOYLSTON ST",
            "address_2": "APT 3",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302115",
            "telephone_number": "617-983-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "address_2": "MEDICAL SERVICE 111",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021324927",
            "telephone_number": "857-203-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUDBERG",
        "first_name": "SARAH",
        "middle_name": "CLARK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "215947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Greene, M.D.
• David Samuel Greenstein, O.D. , M. S.
• Beverly Fay Greenwold, M.D.
• Ashley B Griffin, MSW
• Anna Anush Grigorian, NURSE
• Joseph M Guarino, D.M.D.
• Ali Guermazi, MD
• Erik Kevin Guilfoyle
• Yanchi Guo, OD
• Gustavo Perdomo DMD PC

• Internal Medicine Physician in West Roxbury, MA
• Providers in West Roxbury, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.