Individual provider Active NPI

Benjamin Grugan, MD

  • Emergency Medicine Physician
  • Kenner, LA
National Provider Identifier
1760979074
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101282275 Issued in VA
Practice address
180 W Esplanade Ave
Kenner, LA 70065-2467
Phone
(504) 468-8600
NPI assigned
Apr 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 330275 LA
Emergency Medicine Physician 207P00000X 0101282275 VA Primary

Addresses

Primary practice location

180 W Esplanade Ave
Kenner, LA 70065-2467

Mailing address

180 W Esplanade Ave
Kenner, LA 70065-2467
Phone (504) 468-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, VA2 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
I20220824002202 LA Practitioner - Emergency Medicine 3274916259 Reassigns benefits to 6 organizations
I20241112000919 VA Practitioner - Emergency Medicine 3274916259 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Temple University School of Medicine, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

140 Vista Centre Dr
FL 2
Forest, VA 24551-3965

140 Vista Centre Dr 2ND FL
Forest, VA 24551-3965

220 Campus Blvd
Suite 320
Winchester, VA 22601-2888

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101282275VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Memorial Hospital, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Kenner Emergency Group LLC Emergency Medicine CurrentSince Jul 11, 2022 Accepting new patients
Shenandoah Memorial Hospital, Inc. Current Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Warren Memorial Hospital, Inc. Emergency Medicine CurrentSince Nov 1, 2025 Accepting new patients
Warren Memorial Hospital, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Shenandoah Memorial Hospital Inc. CurrentSince Nov 1, 2025 Accepting new patients
Winchester Medical Center Emergency Medicine CurrentSince Nov 1, 2025 Accepting new patients
St. John Emergency Group LLC Emergency Medicine CurrentSince Jul 11, 2022 Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 14, 2022 Accepting new patients
Luling Emergency Group LLC Emergency Medicine CurrentSince Jul 11, 2022 Accepting new patients
Centra Medical Group, LLC CurrentSince Sep 7, 2024 Accepting new patients
Belle Chasse Emergency Group LLC Emergency Medicine CurrentSince Jul 11, 2022 Accepting new patients
Winchester Medical Center CurrentSince Nov 1, 2025 Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 14, 2022 Accepting new patients
Vincent Emergency Group, LLC Emergency Medicine CurrentSince Jul 11, 2022 Accepting new patients
Winchester Medical Center Current Accepting new patients
Shenandoah Memorial Hospital, Inc. Past Accepting new patients

Locations

180 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-8284

1900 W Airline Hwy
La Place, LA 70068
Phone (985) 652-7000

1057 Paul Maillard Rd
Luling, LA 70070
Phone (985) 785-3655

2700 Napoleon Ave
New Orleans, LA 70115
Phone (504) 842-3650

1514 Jefferson Hwy
New Orleans, LA 70121

1001 Gause Blvd
Slidell, LA 70458
Phone (985) 280-2200

100 Medical Center Dr
Slidell, LA 70461
Phone (504) 392-3131

2500 Belle Chasse Hwy
Terrytown, LA 70056
Phone (504) 391-5157

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

351 Valley Health Way
Front Royal, VA 22630
Phone (540) 636-0300

200 Memorial Dr
Luray, VA 22835
Phone (540) 743-4561

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

240 Shenandoah St
Woodstock, VA 22664
Phone (540) 459-2808

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1760979074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 W ESPLANADE AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652467",
            "telephone_number": "504-468-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W ESPLANADE AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652467",
            "telephone_number": "504-468-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUGAN",
        "first_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-23",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "330275",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101282275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenner, LA

Sources for this page

Verify at the official NPI Registry.