Anthony M Grimaldi, DO

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

036053826 Issued in IL

Practice address

20201 Crawford Ave
Suite 1276
Olympia Fields, IL 60461-1010

Phone

(708) 679-2270

Fax

(708) 679-2272

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1811048812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SIERRA DR",
            "address_2": "SUITE 400",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437240",
            "telephone_number": "317-528-4253",
            "fax_number": "317-865-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20201 CRAWFORD AVE",
            "address_2": "SUITE 1276",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611010",
            "telephone_number": "708-679-2270",
            "fax_number": "708-679-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMALDI",
        "first_name": "ANTHONY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036053826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "21626252",
            "identifier": "BLUE CROSS BLUE SHIE",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "203979055",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah A Green, DO
• Thomas E. Green, DO
• Collin Martin Greer, MD
• Julian Greer
• Kamille Greer, LPC
• Gerald Joseph Gripshover, LCSW
• Kimberly Ann Grospe, MD
• Nicholas Donald Gross
• Giesela Grumbach, PHD
• Joseph Guan, MD, MPH

• Urology Physician in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.