Individual provider Active NPI

Julie A Gronek, M.D.

  • Physical Medicine & Rehabilitation Physician
  • South Burlington, VT
National Provider Identifier
1558310300
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
042.0019135 Issued in VT
Practice address
192 Tilley Dr
South Burlington, VT 05403-4440
Phone
(802) 847-0318
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301078628 MI
Physical Medicine & Rehabilitation Physician 208100000X 042.0019135 VT Primary

Addresses

Primary practice location

192 Tilley Dr
South Burlington, VT 05403-4440

Mailing address

192 Tilley Dr
South Burlington, VT 05403-4440
Phone (802) 847-0318

Other practice location 1

790 College Pkwy
Colchester, VT 05446-3007
Phone (802) 847-0318

Other identifiers 1

IdentifierTypeStateIssuer
4584712MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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

Enrollment IDStateProvider typePAC IDDetails
I20260130001573 VT Practitioner - Physical Medicine and Rehabilitation 4587645791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Michigan State University College of Human Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301078628MIMDPhysical Medicine & Rehabilitation Physician
042.0019135VTMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Physical Medicine & Rehabilitation CurrentSince Feb 1, 2026 Accepting new patients
Battle Creek Vamc CurrentSince Jul 24, 2022 Accepting new patients

Locations

5838 Metro Way SW
Wyoming, MI 49519
Phone (616) 249-5300

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

192 Tilley Dr
South Burlington, VT 05403
Phone (802) 847-2663

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1558310300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 TILLEY DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034440",
            "telephone_number": "802-847-0318",
            "fax_number": "802-847-6846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 TILLEY DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034440",
            "telephone_number": "802-847-0318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 College Pkwy",
            "address_purpose": "LOCATION",
            "city": "Colchester",
            "state": "VT",
            "postal_code": "054463007",
            "country_code": "US",
            "telephone_number": "802-847-0318",
            "fax_number": "802-847-6846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRONEK",
        "first_name": "JULIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301078628",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VT",
            "license": "042.0019135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4584712",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.