Active NPI
Lewis Groden, MD
- Ophthalmology Physician
- Tampa, FL
National Provider Identifier
1609896828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- ME41246
- Practice address
- 12901 Bruce B Downs Blvd
Tampa, FL 33612-4742 - Phone
- (813) 974-3820
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | ME41246 | FL | Primary |
Addresses
Primary practice location
12901 Bruce B Downs Blvd
Tampa, FL 33612-4742
Mailing address
PO Box 917770
Orlando, FL 32891-0001
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 068488100 | Medicaid | FL | |
| 30538 | Other | FL | BLUE CROSS BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lgroden6320@direct.tgh.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Promoting interoperability
- 0
- Improvement activities
- 0
- Cost
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME41246 | FL | MD | Ophthalmology Physician |
Interoperability endpoints
- lgroden6320@direct.tgh.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1609896828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328910001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12901 BRUCE B DOWNS BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336124742",
"telephone_number": "813-974-3820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRODEN",
"first_name": "LEWIS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "FL",
"license": "ME41246",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "068488100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "30538",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lgroden6320@direct.tgh.org",
"affiliation": "N",
"address_1": "12901 Bruce B Downs Blvd",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336124742",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.