Mark Richard Gruidl, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP8286 Issued in CA

Practice address

1020 Fava CT
Templeton, CA 93465-3826

Phone

(805) 748-8897

Fax

(805) 434-0308

NPI assigned

Sep 30, 2005

Sex

Male

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 CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

22.18 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

73.94

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Geriatric Healthcare Inc

  • Nurse Practitioner
  • Cayucos, CA
  • NPI 1306835731
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1427045848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2677",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934232677",
            "telephone_number": "805-748-8897",
            "fax_number": "805-434-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 FAVA CT",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934653826",
            "telephone_number": "805-748-8897",
            "fax_number": "805-434-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUIDL",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP8286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurel Gilbert, PH.D
• Great Pacific Medical Group Inc
• Kathryn M Green, LMFT
• Nancy Greenman, NP
• Dianne Gross-Giese, OTRL,CHT
• Heather Guthrie-Knowles, LMFT
• Zaid Muhannad Haddadin, MD
• Matthew Hadilaksono, DO
• Thomas Hale, MD
• Julie Dawes Halverson, SLP-CCC, M.A.

• Nurse Practitioner in Templeton, CA
• Providers in Templeton, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.