Individual provider Active NPI

Mary Jo Groves, M.D.

  • Family Medicine Physician
  • Friday Harbor, WA
National Provider Identifier
1730124371
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.046580 Issued in OH
Practice address
1117 Spring St
Friday Harbor, WA 98250
Phone
(360) 378-2141
Fax
(360) 378-1785
NPI assigned
Jun 18, 2006
Last updated
Aug 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G156583 CA
Family Medicine Physician 207Q00000X 35.046580 OH Primary

Addresses

Primary practice location

1117 Spring St
Friday Harbor, WA 98250

Mailing address

2665 Derr Road
Springfield, OH 45503-3774

Other practice location 1

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 340-3911 ext. 7920

Other identifiers 1

IdentifierTypeStateIssuer
0466473MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061121000192 OH Practitioner - Family Practice 7416955794 Reassigns benefits to 2 organizations
I20180910002092 CA Practitioner - Family Practice 7416955794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
85.37
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G156583CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center Current Accepting new patients
Apogee Medical Group Ohio Inc CurrentSince Jan 12, 2016 Accepting new patients
Eisenhower Medical Center CurrentSince Aug 18, 2018 Accepting new patients
Eisenhower Medical Center CurrentSince Aug 18, 2018 Accepting new patients
Hospitalist Medicine Physicians of Richland County, LTD Family Medicine CurrentSince Dec 17, 2023 Accepting new patients
Hospital Services Medical Group of Clark County Inc Past Accepting new patients

Locations

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

39000 Bob Hope Dr
Ofc
Rancho Mirage, CA 92270
Phone (760) 333-1813

39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053

72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

904 Scioto St
Urbana, OH 43078
Phone (937) 293-0136

Interoperability endpoints

  • Direct secure messaging: mgroves344948@direct.peacehealth.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1730124371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 DERR ROAD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455033774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 SPRING ST",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "98250",
            "telephone_number": "360-378-2141",
            "fax_number": "360-378-1785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39000 Bob Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Rancho Mirage",
            "state": "CA",
            "postal_code": "922703221",
            "country_code": "US",
            "telephone_number": "760-340-3911 x7920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROVES",
        "first_name": "MARY JO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G156583",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.046580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0466473",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Friday Harbor, WA

Sources for this page

Verify at the official NPI Registry.