John Ray Groeneveld, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

406754 Issued in MI

Practice address

440 Woodward Ave
Iron Mountain, MI 49801-4631

Phone

(906) 776-9040

Fax

(906) 774-7279

NPI assigned

Jul 21, 2005

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Family Practice

Education

Michigan State University College of Human Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dickinson Home Health Home health agency, Iron Mountain, MI, CCN 237292
• Marshfield Medical Center Hospital, Iron Mountain, MI, CCN 231342
• Dickinson County Memorial Hospital Hospital, Iron Mountain, MI, CCN 230055
• Aspirus Iron River Hospital & Clinics, Inc Hospital, Iron River, MI, CCN 231318
• Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgroeneveld173681@direct.thedacare.org
• Direct secure messaging: jgroeneveld916801@direct.emplifyhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bellin Memorial Hospital Inc

  dba Bellin Health Heart & Vascular Crystal Falls

  • Cardiovascular Disease Physician
  • Crystal Falls, MI
  • NPI 1376649509
  Medicare reassignment Care Compare group NPD
• Bellin Memorial Hospital Inc

  dba FMC Iron Mountain

  • Family Medicine Physician
  • Iron Mountain, MI
  • NPI 1790045078
  NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Bellin Memorial Hospital Inc

  dba FMC Brillion

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)

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

• Aspirus Iron River Hospital & Clinics, Inc.

  dba Aspirus Iron River Clinic

  • Multi-Specialty Clinic/Center
  • Iron River, MI
  • NPI 1457865198

  Hospital

  Care Compare affiliation
• Aspirus Iron River Hospital & Clinics, Inc.

  dba Aspirus Iron River Hospital

  • Critical Access Hospital
  • Iron River, MI
  • NPI 1497750830
  Care Compare affiliation
• Dickinson County Healthcare System

  dba Marshfield Medical Center - Dickinson Home Health (HHA)

  • Home Health Agency
  • Iron Mountain, MI
  • NPI 1063443430
  Care Compare affiliation
• Dickinson County Healthcare System

  dba Marshfield Medical Center - Dickinson

  • Critical Access Hospital
  • Iron Mountain, MI
  • NPI 1841188604
  Care Compare affiliation
• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585
  Care Compare affiliation

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1467452391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WOODWARD AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014631",
            "telephone_number": "906-776-9040",
            "fax_number": "906-774-7279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 East Blvd",
            "address_purpose": "LOCATION",
            "city": "Kingsford",
            "state": "MI",
            "postal_code": "498024436",
            "country_code": "US",
            "telephone_number": "906-774-4000",
            "fax_number": "906-774-0088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROENEVELD",
        "first_name": "JOHN",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "406754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01692639",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1994486",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31491800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Gray, LMSW
• Great Lakes Recovery Centers
• Green Bay Cardiothoracic & Vascular, LLC
• Greenlund Enterpries, Inc
• Cheryl Ann Griggs, D.C.
• Syvannah Groeneveld
• Susan Marie Grondin, APNP
• Deborah J Gross, MSW CSW
• Sarita Louise Gruszynski, CAPSW
• Maryssa Gussert

• Family Medicine Physician in Iron Mountain, MI
• Providers in Iron Mountain, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.