Edward M Ewald, MD
Individual provider Active NPI Family Medicine Physician · East Granby, CT
NPI 1497732564 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1497732564
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 018024 (CT)
- Practice address
- 13 Church Rd
East Granby, CT 06026-0518 - Phone
- (860) 653-4526
- Fax
- (860) 653-5209
- NPI assigned
- Dec 29, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Hahnemann University College of Medicine, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- East Granby Family Practice LLC
McLean Fund
Practice addresses (Care Compare)
13 Church Rd
East Granby, CT 06026-9406
Phone (860) 653-4526
75 Great Pond Rd
Simsbury, CT 06070-1980
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 13 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110124000180 | CT | Practitioner - Family Practice | 1153515119 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018024 | CT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Granby Family Practice LLC | Family Medicine | Current |
Accepting new patients |
Locations
13 Church Rd
East Granby, CT 06026
Phone (860) 653-4526
Interoperability endpoints
- edward.ewald.1@28841.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 018024 | CT | Yes |
Addresses
Primary practice location
13 Church Rd
East Granby, CT 06026-0518
Mailing address
PO Box 518
13 Church Rd
East Granby, CT 06026-0518
Phone (860) 653-4526
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0204022002 | Other | CT | CIGNA |
| 00118024900 | Other | CT | BLUECARE FAMILY |
| 0104405 | Other | CT | UNITED |
| 010018024CT01 | Other | CT | BCBS |
| 781463 | Other | CT | CT |
| HAP209 | Other | CT | OXFORD |
| 140066 | Other | CT | AETNA |
| 0P0373 | Other | CT | HEALTHNET |
Other providers in East Granby, CT
- East Granby Board of Education
- East Granby Family Practice LLC
- Educational Advancement Associates
- Ellsworth Medical, LLC
- Maureen Elizabeth Emery
- Ellen Farmer Lanctot
- Kristen Formanek
- Fortify Wellness and Physical Therapy LLC
- Elizabeth S Freedman
- Khuram R Ghumman
All providers in East Granby, CT · Family Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.