Individual provider Active NPI

Thomas Matthew Grogan, M.D.

  • Anesthesiology Physician
  • Newark, OH
National Provider Identifier
1821250895
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
249311 Issued in NY
Practice address
1320 W Main St
Newark, OH 43055-1822
Phone
(220) 564-4218
Fax
(220) 564-4217
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 249311 NY Primary

Addresses

Primary practice location

1320 W Main St
Newark, OH 43055-1822

Mailing address

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4218

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tgrogan30572@lickingmemorial.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, OH2 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
I20110616000790 NY Practitioner - Anesthesiology 4789862905 Reassigns benefits to 1 organization
I20221221002580 OH Practitioner - Anesthesiology 4789862905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Columbia University College of Physicians and Surgeons, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Licking Memorial Health ProfessionalsGroup PAC ID 6204740731, 235 clinicians

Practice addresses (Care Compare)

1320 W Main St
Licking Memorial Anesthesiology
Newark, OH 43055-1822
Phone (220) 564-4226

Hospital & facility affiliations

  • Licking Memorial Hospital Hospital, Newark, OH, CCN 360218

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Jul 1, 2011 Accepting new patients
Optum Medical Care, P.C. CurrentSince Oct 12, 2020 Accepting new patients
Licking Memorial Professional Corporation CurrentSince Dec 13, 2022 Accepting new patients
Licking Memorial Health Professionals CurrentSince Dec 13, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Oct 12, 2020 Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

600 Westage Business Ctr Dr
#D
Fishkill, NY 12524

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

71 Prospect Ave
Hudson, NY 12534
Phone (518) 262-3773

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

21 Reade Pl
Ste 2200
Poughkeepsie, NY 12601
Phone (845) 483-0698

2000 Tamarack Rd
Newark, OH 43055
Phone (740) 788-6000

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

Philadelphia, PA 19195

Organizations & group practices 5

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 1

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": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1821250895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551822",
            "telephone_number": "220-564-4218",
            "fax_number": "220-564-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551822",
            "telephone_number": "220-564-4218",
            "fax_number": "220-564-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROGAN",
        "first_name": "THOMAS",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "249311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgrogan30572@lickingmemorial.medicity.net",
            "affiliation": "N",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.