Richard Warren Grodin, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME26691 Issued in FL

Practice address

365 Stirrup Key Blvd
Marathon, FL 33050-2943

Phone

(954) 363-1011

Fax

(561) 807-7836

NPI assigned

Feb 19, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Nursing Home Consultants LLC

  • Internal Medicine Physician
  • Marathon, FL
  • NPI 1033346945
  NPD (past)
• Retina Vitreous Consultants

  • Ophthalmology Physician
  • Ft Lauderdale, FL
  • NPI 1699773796
  NPD (past)

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1700054178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 VICTORIA ISLE WAY",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333271315",
            "telephone_number": "954-650-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 STIRRUP KEY BLVD",
            "city": "MARATHON",
            "state": "FL",
            "postal_code": "330502943",
            "telephone_number": "954-363-1011",
            "fax_number": "561-807-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODIN",
        "first_name": "RICHARD",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME26691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
            "identifier": "93294",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281015800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Global Sky Aircharter Corporation
• Roxana Gomez Perez
• Rita Gonzalez
• Yaimi Gonzalez
• Good Shepherd Hospice, Inc.
• Guidance Care Center
• Guidance Care Center
• Guidance Care Center
• Guidance Care Center
• Guidance Care Center, Inc.

• Ophthalmology Physician in Marathon, FL
• Providers in Marathon, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.