Individual provider Active NPI

Robert R Grondin, DPM

  • Foot Surgery Podiatrist
  • Worcester, MA
National Provider Identifier
1508038217
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
2318 Issued in MA
Practice address
299 Lincoln St
Suite 202
Worcester, MA 01605-3646
Phone
(508) 757-4003
Fax
(508) 755-7592
NPI assigned
Apr 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 2318 MA Primary

Addresses

Primary practice location

299 Lincoln St
Suite 202
Worcester, MA 01605-3646

Mailing address

123 Summer St
Ste 550
Worcester, MA 01608-1216
Phone (508) 363-6868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081112000428 MA Practitioner - Podiatry 7517026032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paul a Cournoyer DPM PCGroup PAC ID 3375525702, 3 clinicians

Practice addresses (Care Compare)

123 Summer St
Suite 550
Worcester, MA 01608-1216
Phone (508) 363-6868

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176
  • Milford Regional Medical Center Hospital, Milford, MA, CCN 220090

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue191
Removal of skin lesions1-10
Removal of nail tissue1378
Removal or shaving of skin growth499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paul a. Cournoyer D.P.M., P.C. Foot Surgery CurrentSince Aug 1, 2022 Accepting new patients
Carol a. Barrette, M.D. P.C. Past Accepting new patients

Locations

72 Cudworth Rd
Ste 2
Webster, MA 01570
Phone (508) 363-6363

123 Summer St
#550
Worcester, MA 01608
Phone (508) 363-6868

123 Summer St
Ste 550
Worcester, MA 01608
Phone (508) 363-6868

Interoperability endpoints

  • Direct secure messaging: robert.grondin.1@12878.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1508038217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "address_2": "STE 550",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-6868",
            "fax_number": "508-363-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 LINCOLN ST",
            "address_2": "SUITE 202",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053646",
            "telephone_number": "508-757-4003",
            "fax_number": "508-755-7592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONDIN",
        "first_name": "ROBERT",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-02",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MA",
            "license": "2318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.