Individual provider Active NPI

Eric D Gruen, D.P.M.

  • Podiatrist
  • Dawsonville, GA
National Provider Identifier
1710953088
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD000924 Issued in GA
Practice address
400 Dawson Commons Cir Ste 420
Dawsonville, GA 30534
Phone
(706) 216-8637
Fax
(815) 550-9967
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004948 NY
Podiatrist 213E00000X POD000924 GA Primary

Addresses

Primary practice location

400 Dawson Commons Cir Ste 420
Dawsonville, GA 30534

Mailing address

400 Dawson Commons Cir Ste 420
Dawsonville, GA 30534-6269
Phone (706) 216-8637

Other practice location 1

410 Farmwood Way
Canton, GA 30115-8913
Phone (678) 549-3201

Other identifiers 3

IdentifierTypeStateIssuer
4418670001OtherGADMERC NUMBER
000925878AMedicaidGA
POD000924OtherGAPODIATRY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190508003318 GA Practitioner - Podiatry 2769444280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Dawson Commons Cir
Suite 420
Dawsonville, GA 30534-6269
Phone (706) 216-8637

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue91
Removal of skin lesions1-10
Removal of nail tissue2558
Removal or shaving of skin growth427
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
000924GAMDClinical Social Worker
POD000924GAMDPodiatrist
N004948NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric D. Gruen D.P.M., P.C. Podiatrist CurrentSince May 1, 2016 Accepting new patients
Bruce a Pichler DPM PC Past Accepting new patients

Locations

222 Moores Dr
Dahlonega, GA 30533
Phone (706) 864-3045

59 Tipton Dr
Dahlonega, GA 30533
Phone (706) 864-4012

400 Dawson Commons Cir
Ste 420
Dawsonville, GA 30534
Phone (706) 216-8637

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16085/brand/1/csg/1/fhir/r4

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1710953088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 DAWSON COMMONS CIR STE 420",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346269",
            "telephone_number": "706-216-8637",
            "fax_number": "815-550-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 DAWSON COMMONS CIR STE 420",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "30534",
            "telephone_number": "706-216-8637",
            "fax_number": "815-550-9967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Farmwood Way",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301158913",
            "country_code": "US",
            "telephone_number": "678-549-3201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUEN",
        "first_name": "ERIC",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004948",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD000924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC NUMBER",
            "identifier": "4418670001",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000925878A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PODIATRY LICENSE",
            "identifier": "POD000924",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

Verify at the official NPI Registry.