Fred L Groos, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28880-020 Issued in WI

Practice address

1414 W Fair Ave Ste 242
Marquette, MI 49855-5406

Phone

(906) 449-2900

Fax

(906) 449-2975

NPI assigned

Jun 8, 2005

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Upper Great Lakes Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Laurium, MI
  • NPI 1114788619
  NPD
• Upper Great Lakes Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Gwinn, MI
  • NPI 1700103777

  Family Medicine

  NPD

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1467456400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 EXPLORER ST",
            "city": "GWINN",
            "state": "MI",
            "postal_code": "498412813",
            "telephone_number": "906-346-4924",
            "fax_number": "906-346-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE STE 242",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498555406",
            "telephone_number": "906-449-2900",
            "fax_number": "906-449-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOS",
        "first_name": "FRED",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "28880-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31367800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART A - CLINIC",
            "identifier": "521823",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE A MOBIL UNIT",
            "identifier": "521824",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendi J Greer, MSW
• Erica Joan Griffin, MD
• Phyllis Griffin
• Stephane Grijseels, MD
• Grisham Services Inc.
• Brandon Patrick Gross, LLMSW
• Michelle Grunert, LMSW
• Steven M Gualdoni, PAC
• Courtney Guidebeck, LMSW
• David Edward Guinn, NP

• Family Medicine Physician in Marquette, MI
• Providers in Marquette, 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 Apr 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.