Individual provider Active NPI

Kirsten Ruth Groody, MD

  • Pediatric Anesthesiology Physician
  • Ann Arbor, MI
National Provider Identifier
1417477068
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
4301509522 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Jun 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD475892 PA
Pediatric Anesthesiology Physician 207LP3000X MD475892 PA
Pediatric Anesthesiology Physician 207LP3000X 4301509522 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone (800) 879-2467

Other practice location 2

550 S Goddard Blvd
King Of Prussia, PA 19406-2922
Phone (610) 337-3232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230912002319 MI Practitioner - Anesthesiology 4486924826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loyola University of Chicago, Stritch School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000

1500 E Medical Ctr Dr 1St FL
Taubman Ctr Rec D
Ann Arbor, MI 48109-5000
Phone (734) 936-4185

1500 E Medical Ctr Dr 1St FL Rec D
Taubman Center
Ann Arbor, MI 48109-5000
Phone (734) 764-5175

1500 E Medical Ctr Dr 1St FL Rec F
Mott Hospital
Ann Arbor, MI 48109-5000
Phone (734) 764-5176

1500 E Medical Ctr Dr 3Rd FL Taubma
Ann Arbor, MI 48109-5000
Phone (734) 647-7321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD475892PAMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Aug 22, 2023 Accepting new patients
Edward W. Sparrow Hospital Association Anesthesiology CurrentSince Sep 10, 2024 Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Sep 10, 2024 Accepting new patients
Regents of the University of Michigan Anesthesiology CurrentSince Aug 22, 2023 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1500 E Medical Center Dr
#241
Ann Arbor, MI 48109

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

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": "1498348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1417477068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Civic Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "800-879-2467",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 S Goddard Blvd",
            "address_purpose": "LOCATION",
            "city": "King Of Prussia",
            "state": "PA",
            "postal_code": "194062922",
            "country_code": "US",
            "telephone_number": "610-337-3232",
            "fax_number": "610-337-0325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROODY",
        "first_name": "KIRSTEN",
        "middle_name": "RUTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-25",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD475892",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "PA",
            "license": "MD475892",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MI",
            "license": "4301509522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.