Individual provider Active NPI

Richard L Grotz, M.D.

  • Surgery Physician
  • Brockton, MA
National Provider Identifier
1801865662
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
77137 Issued in MA
Practice address
1 Pearl St
Suite 2700
Brockton, MA 02301-2864
Phone
(508) 584-4104
Fax
(508) 584-4105
NPI assigned
Mar 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 77137 MA Primary

Addresses

Primary practice location

1 Pearl St
Suite 2700
Brockton, MA 02301-2864

Mailing address

1350 Belmont St
Suite 102
Brockton, MA 02301-4430
Phone (774) 776-2991

Other identifiers 9

IdentifierTypeStateIssuer
P00092280OtherMARR MEDICARE
14-00003OtherMAUNITED HEALTHCARE
300852540OtherMAHEALTHNET
0013819OtherMANEIGHBORHOOD HEALTH
29256OtherMAHARVARD PILGRIM
3109950MedicaidMA
77137OtherMATUFTS PROV#
GRJ13652OtherMABLUE CROSS BLUE SHIELD
454450OtherMAAETNA HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1801865662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BELMONT ST",
            "address_2": "SUITE 102",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014430",
            "telephone_number": "774-776-2991",
            "fax_number": "774-776-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PEARL ST",
            "address_2": "SUITE 2700",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012864",
            "telephone_number": "508-584-4104",
            "fax_number": "508-584-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTZ",
        "first_name": "RICHARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "77137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00092280",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "14-00003",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "300852540",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0013819",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "29256",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3109950",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PROV#",
            "identifier": "77137",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "GRJ13652",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTHCARE",
            "identifier": "454450",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.