Laurence Shane Grundy, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

ME71962 Issued in FL

Practice address

2330 Utah Ave Ste 200
El Segundo, CA 90245-4817

Phone

(281) 766-0959

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Interventional RadiologyAlso: Diagnostic Radiology

Education

University of South Florida College of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Tower Imaging LLCGroup PAC ID 2860470077, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tampa General Hospital Hospital, Tampa, FL, CCN 100128

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: lgrundy19012@direct.tgh.org
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Mori Bean and Brooks Inc

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1093782070
  Medicare reassignment Care Compare group NPD
• Tower Imaging LLC

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1467654244
  Medicare reassignment Care Compare group NPD
• Medical Technology Transfer Corporation

  • Primary Care Clinic/Center
  • Melbourne, FL
  • NPI 1104947217
  Medicare reassignment NPD
• University Medical Service Association Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1992742324
  Medicare reassignment NPD
• Medical Technology Transfer Corporation

  • Radiology Clinic/Center
  • Melbourne, FL
  • NPI 1215017710
  NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• Tower Imaging LLC

  • Diagnostic Radiology Physician
  • Spring Hill, FL
  • NPI 1669267134
  NPD
• University Medical Service Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1194276576
  NPD
• University Medical Service Association Inc

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1861432775
  NPD
• Boca Radiology Group PA

  • Diagnostic Radiology Physician
  • Boca Raton, FL
  • NPI 1033163423
  NPD (past)
• Mountain Radiology, Inc

  • Diagnostic Radiology Physician
  • Grand Junction, CO
  • NPI 1003401506
  NPD (past)
• Tower Imaging LLC

  • Diagnostic Radiology Physician
  • Lutz, FL
  • NPI 1629218573
  NPD (past)

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

• Florida Health Sciences Center Inc

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1235196510
  Care Compare affiliation

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1649239054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 UNIVERSITY SQUARE DRIVE",
            "address_2": "RADIOLOGY ASSOCIATES OF TAMPA",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125513",
            "telephone_number": "813-251-5822",
            "fax_number": "813-254-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 UTAH AVE STE 200",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454817",
            "telephone_number": "281-766-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNDY",
        "first_name": "LAURENCE",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME71962",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME71962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118774",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261385900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Grisales
• Karla Grobbelaar
• Autumn Gross
• Lisa Grossman, RN, IBCLC
• Eva Grubaugh
• GS & Kale Chiropractic Inc
• Denise Guadarrama
• Iseah Gudino
• Jessica Gudino
• Kayleen Gudino

• Vascular & Interventional Radiology Physician in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Vascular & Interventional Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.