Individual provider Active NPI

Brian Edward Grottkau, MD

  • Orthopaedic Surgery Physician
  • Miami, FL
National Provider Identifier
1477543080
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
166008 Issued in FL
Practice address
1120 NW 14TH St Ste 1263
Miami, FL 33136-2107
Phone
(305) 243-3208
Fax
(305) 243-0338
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 76630 MA
Orthopaedic Surgery Physician 207X00000X 166008 FL Primary

Addresses

Primary practice location

1120 NW 14TH St Ste 1263
Miami, FL 33136-2107

Mailing address

1120 NW 14TH St Ste 1263
Miami, FL 33136-2107
Phone (305) 243-3208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, FL2 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

Enrollment IDStateProvider typePAC IDDetails
I20040707000807 MA Practitioner - Orthopedic Surgery 7214914274 Reassigns benefits to 2 organizations
I20240131001615 FL Practitioner - Orthopedic Surgery 7214914274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1400 NW 12TH Ave
Miami, FL 33136-1003
Phone (305) 689-7272

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166008FLMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Orthopaedic Surgery CurrentSince Dec 14, 1994 Accepting new patients
University of Miami Orthopaedic Surgery CurrentSince Dec 30, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Oct 1, 2006 Accepting new patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Dec 30, 2023 Accepting new patients
University of Miami Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1400 NW 12th Ave
Ste 2
Miami, FL 33136
Phone (305) 325-5691

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

1400 NW 12th Ave
Miami, FL 33136
Phone (305) 325-5416

1120 NW 14th St
Ste 1263
Miami, FL 33136
Phone (305) 243-3208

55 Fruit St
Boston, MA 02114

55 Fruit St
#3
Boston, MA 02114
Phone (617) 724-6620

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

15 Parkman St
#507
Boston, MA 02114
Phone (617) 726-8523

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

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": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1477543080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 NW 14TH ST STE 1263",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331362107",
            "telephone_number": "305-243-3208",
            "fax_number": "305-243-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 NW 14TH ST STE 1263",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331362107",
            "telephone_number": "305-243-3208",
            "fax_number": "305-243-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTTKAU",
        "first_name": "BRIAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "76630",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "166008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.