Mordechai Groner, M.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

MD61151650 Issued in WA

Practice address

3525 Ensign Rd NE Ste F
Olympia, WA 98506-5065

Phone

(360) 493-4001

Fax

(360) 438-2026

NPI assigned

Apr 6, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, CA2 enrollments

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 2

Specialty

Infectious Disease

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Martin Luther King Jr Community Medical FoundationGroup PAC ID 8628359502, 193 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Martin Luther King, Jr. Community Hospital Hospital, Los Angeles, CA, CCN 050779

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Martin Luther King Jr Community Medical Foundation

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1356899777
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment NPD
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997
  Medicare reassignment NPD
• Providence Health & Services Washington

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Olympia, WA
  • NPI 1023550050
  NPD
• Martin Luther King Jr Community Medical Foundation

  • Multi-Specialty Clinic/Center
  • Compton, CA
  • NPI 1306496641
  NPD
• Martin Luther King Jr Community Medical Foundation

  • Radiology Clinic/Center
  • Los Angeles, CA
  • NPI 1346082294
  NPD
• Regional Health Services Inc

  • Family Medicine Physician
  • Erie, PA
  • NPI 1174520654
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Martin Luther King, Jr. - Los Angeles (MLK-la) Healthcare Corporation

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1114367497
  Care Compare affiliation

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1427347764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 ENSIGN RD NE STE F",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065065",
            "telephone_number": "360-493-4001",
            "fax_number": "360-438-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 ENSIGN RD NE STE F",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065065",
            "telephone_number": "360-493-4001",
            "fax_number": "360-438-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONER",
        "first_name": "MORDECHAI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036148227",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WA",
            "license": "MD61151650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgroner1632128@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3525 Ensign Rd NE Ste F",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James H. Grimes, O.D.
• Shawn Grimes
• Tracy Ann Grimes, PT
• Deanna Grivel
• Kirsten Grohe, LMP
• Barbara Gross
• Debra J Gross, ARNP
• Heather Gross
• Terri Lynn Grosshans, PA-C
• Mikaila Grosso, LMT

• Infectious Disease Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Infectious Disease Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.