NPIMap

Individual provider Active NPI

Thomas Joseph Gruber, M.D.

  • Anesthesiology Physician
  • Rockford, IL
National Provider Identifier
1811085202
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Practice address
1603 Arden Ave
Rockford, IL 61107-2027
Phone
(815) 262-3001
Fax
(815) 229-2508
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 41045 CO
Anesthesiology Physician 207L00000X 2003027199 MO
Anesthesiology Physician 207L00000X IL Primary

Addresses

Primary practice location

1603 Arden Ave
Rockford, IL 61107-2027

Mailing address

1603 Arden Ave
Rockford, IL 61107-2027
Phone (815) 262-3001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041101000530 IL Practitioner - Anesthesiology 7416919584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Vanderbilt University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5654

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

600 S 13TH St
Pekin, IL 61554-4936
Phone (309) 347-1151

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
  • Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41045COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois CurrentSince Jul 7, 2008 Accepting new patients
Methodist Medical Center of Illinois Anesthesiology CurrentSince Jul 7, 2008 Accepting new patients
Carle Health Care Incorporated Anesthesiology CurrentSince Jan 1, 2026 Accepting new patients
Anesthesia Associates of Kansas City PA Anesthesiology Past Accepting new patients
DM Physicians of Belleville Il, LLC Past Accepting new patients

Locations

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 12

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.

Hospital & facility affiliations 4

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811085202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 ARDEN AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072027",
            "telephone_number": "815-262-3001",
            "fax_number": "815-229-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 ARDEN AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072027",
            "telephone_number": "815-262-3001",
            "fax_number": "815-229-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "41045",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2003027199",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.