Individual provider Active NPI

Jon M McGruder, MD

  • Anesthesiology Physician
  • Norfolk, VA
National Provider Identifier
1417976515
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Practice address
600 Gresham Dr
Norfolk, VA 23507-1904
Phone
(757) 668-3871
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X VA Primary

Addresses

Primary practice location

600 Gresham Dr
Norfolk, VA 23507-1904

Mailing address

134 Business Park Dr
Virginia Beach, VA 23462-6523
Phone (757) 473-0055

Other identifiers 2

IdentifierTypeStateIssuer
5709105MedicaidVA
5737788MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20100824001285 VA Practitioner - AnesthesiologyPractitioner - Pain Management 2769506955 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.76 of 100Reported as group
Quality
78.69
Improvement activities
40
Cost
74.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101043536VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Anesthesia, Inc Anesthesiology CurrentSince Aug 19, 1997 Accepting new patients
Consultants in Pain Management, Inc Anesthesiology CurrentSince Aug 1, 1989 Accepting new patients

Locations

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

830 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-6000

134 Business Park Dr
Virginia Beach, VA 23462
Phone (757) 473-0044

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1417976515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 BUSINESS PARK DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626523",
            "telephone_number": "757-473-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-668-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRUDER",
        "first_name": "JON",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5709105",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5737788",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.