Individual provider Active NPI

Lori-Anne Tungpalan-Grondolsky, MD

  • Anesthesiology Physician
  • Chillicothe, OH
National Provider Identifier
1699887810
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
44120 Issued in MN
Practice address
272 Hospital Rd
Chillicothe, OH 45601-9031
Phone
(740) 779-7540
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35084620 OH
Anesthesiology Physician 207L00000X 14755 HI
Anesthesiology Physician 207L00000X 44120 MN Primary

Addresses

Primary practice location

272 Hospital Rd
Chillicothe, OH 45601-9031

Mailing address

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (740) 779-7540

Other practice location 1

2550 University Ave W Ste 423
Saint Paul, MN 55114-1052
Phone (612) 871-1145

Other identifiers 3

IdentifierTypeStateIssuer
2515362MedicaidOH
P00180905OtherOHRAILROAD MEDICARE
000000344370OtherOHANTHEM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena@adena.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20041101000475 OH Practitioner - Anesthesiology 6103888268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Hawaii John a. Burns School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adena Medical Group LLCGroup PAC ID 1153456579, 384 clinicians

Practice addresses (Care Compare)

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (740) 779-8575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.93 of 100Reported as group
Quality
64.42
Promoting interoperability
99
Improvement activities
40
Cost
73.2

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14755HIMDAnesthesiology Physician
35084620OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC Anesthesiology CurrentSince May 27, 2020 Accepting new patients
Affiliated Endoscopy Centers, LLC PastSince Jan 17, 2017 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Mngi Endoscopy ASC Inc PastSince Apr 2, 2018 Accepting new patients

Locations

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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 1

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1699887810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 HOSPITAL RD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019031",
            "telephone_number": "740-779-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 HOSPITAL RD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019031",
            "telephone_number": "740-779-7540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 University Ave W Ste 423",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551141052",
            "country_code": "US",
            "telephone_number": "612-871-1145",
            "fax_number": "612-870-5491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUNGPALAN-GRONDOLSKY",
        "first_name": "LORI-ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35084620",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "HI",
            "license": "14755",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "44120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2515362",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00180905",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000344370",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena@adena.medicity.net",
            "affiliation": "N",
            "address_1": "272 Hospital Rd",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456019031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.