Joseph M Grzelak IV, MD
Individual provider Active NPI Family Medicine Physician · Burlington, KY
NPI 1669950671 · NPPES record last updated Jul 11, 2023
Key facts
- NPI
- 1669950671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 54914 (KY)
- Practice address
- 6105 1St Financial Dr
Burlington, KY 41005-7892 - Phone
- (859) 586-8200
- Fax
- (859) 586-8233
- NPI assigned
- Aug 1, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Concord Hospital Inc
Practice addresses (Care Compare)
121 Pembroke St
Pembroke, NH 03275-1311
Phone (603) 485-8441
Hospital & facility affiliations
- Granite Vna, Inc
- Concord Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- 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 |
|---|---|---|---|---|
| I20250828004562 | NH | Practitioner - Family Practice | 3274938501 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54914 | KY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Concord Hospital, Inc. | Current | Accepting new patients | |
| Concord Hospital, Inc. | Current |
Accepting new patients | |
| Summit Medical Group, Inc. | Current |
Accepting new patients | |
| Concord Hospital, Inc. | Current |
Accepting new patients | |
| Summit Medical Group, Inc | Family Medicine | Current |
Accepting new patients |
Locations
6105 1st Financial Dr
Burlington, KY 41005
Phone (859) 525-1846
7766 Ewing Blvd
#L
Florence, KY 41042
Phone (859) 371-1153
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
246 Pleasant St
Concord, NH 03301
Phone (603) 224-1223
250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711
121 Pembroke St
Pembroke, NH 03275
Phone (603) 485-8441
Interoperability endpoints
- jgrzelak229428@direct-prd.stelizabeth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 54914 | KY | Yes |
Addresses
Primary practice location
6105 1St Financial Dr
Burlington, KY 41005-7892
Mailing address
PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 586-8200
Other providers in Burlington, KY
- Amanda Jo Frazier
- Douglas Charles Fussinger
- Elizabeth Gough
- Stacey N Gripshover
- Renee Grote
- Kaelin Deanna Gulla
- Hart Healthcare, PLLC
- Dana Rochelle Hays
- Jennifer S Hoffman
- Homan Chiropractic Inc
All providers in Burlington, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2023. 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.