Individual provider Active NPI

Michele A Grundstein, MD

  • Family Medicine Physician
  • Plantation, FL
National Provider Identifier
1700841228
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME74252 Issued in FL
Practice address
1261 S Pine Island Rd
Plantation, FL 33324-4418
Phone
(954) 370-1900
Fax
(954) 476-6281
NPI assigned
Apr 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME74252 FL Primary

Addresses

Primary practice location

1261 S Pine Island Rd
Plantation, FL 33324-4418

Mailing address

1261 S Pine Island Rd
Plantation, FL 33324-4418
Phone (954) 370-1900

Other identifiers 1

IdentifierTypeStateIssuer
260853700MedicaidFL

Other names 1

  • Dr. Michele A Grundstein Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110330000269 FL Practitioner - Family Practice 4183807019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Stony Brook, School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Medical Centers Inc.Group PAC ID 2668611781, 2 clinicians

Practice addresses (Care Compare)

1261 S Pine Island Rd
Plantation, FL 33324-4418
Phone (954) 370-1900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME74252FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Centers Inc. Current Accepting new patients
Holy Cross Hospital Inc Family Medicine Past Accepting new patients

Locations

1261 S Pine Island Rd
Plantation, FL 33324
Phone (954) 370-1900

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1700841228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 S PINE ISLAND RD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333244418",
            "telephone_number": "954-370-1900",
            "fax_number": "954-476-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 S PINE ISLAND RD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333244418",
            "telephone_number": "954-370-1900",
            "fax_number": "954-476-6281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNDSTEIN",
        "first_name": "MICHELE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME74252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260853700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "GRUNDSTEIN",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.