James Grovenburg, MD

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

181048-1 Issued in NY

Practice address

5 Golden LN
Kerhonkson, NY 12446-1609

Phone

(845) 626-3424

Fax

(845) 626-4627

NPI assigned

Feb 20, 2007

Last updated

Nov 2, 2007By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Family PracticeAlso: Addiction Medicine

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tabasco Family Practice PLLCGroup PAC ID 9234111345, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tabasco Family Practice PLLC

  dba tabasco health care

  • Addiction Medicine (Family Medicine) Physician
  • Kerhonkson, NY
  • NPI 1073701579
  Medicare reassignment Care Compare group NPD
• Mid-Hudson Family Health Institute

  • Family Medicine Physician
  • New Paltz, NY
  • NPI 1326093642
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1710022447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GOLDEN LANE",
            "city": "KERHONKSON",
            "state": "NY",
            "postal_code": "12446",
            "telephone_number": "845-626-3424",
            "fax_number": "845-626-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GOLDEN LN",
            "city": "KERHONKSON",
            "state": "NY",
            "postal_code": "124461609",
            "telephone_number": "845-626-3424",
            "fax_number": "845-626-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVENBURG",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NY",
            "license": "181048-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01805201",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Lyn Decicco
• Eclipse Physical Therapy and Wellness LLC
• Holly E Elliott, D.C.
• Fransiscus Xaverius DDS, PLLC
• Jennifer Suzanne Graham, RN
• Lucinda Grovenburg, MD
• Helen K. Harkaspi, LCSW-R
• Phyllis Hart, NP, PA
• Bunnysue Healy, R.N.
• Melanie Ingham, RN

• Addiction Medicine (Family Medicine) Physician in Kerhonkson, NY
• Providers in Kerhonkson, NY by specialty
• Addiction Medicine (Family Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.