Marshall P Grodofsky, MD

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

027137 Issued in CT

Practice address

836 Farmington Avenue
Suite 207
West Hartford, CT 06119

Phone

(860) 232-9911

Fax

(860) 233-5996

NPI assigned

Nov 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Connecticut Asthma & Allergy Center LLC

  • Clinical & Laboratory Immunology (Allergy & Immunology) Physician
  • West Hartford, CT
  • NPI 1386604270
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1841271699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 FARMINGTON AVENUE",
            "address_2": "SUITE 207",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "06119",
            "telephone_number": "860-232-9911",
            "fax_number": "860-233-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 FARMINGTON AVENUE",
            "address_2": "SUITE 207",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "06119",
            "telephone_number": "860-232-9911",
            "fax_number": "860-233-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODOFSKY",
        "first_name": "MARSHALL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CT",
            "license": "027137",
            "primary": false
        },
        {
            "code": "207KI0005X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": "CT",
            "license": "027137",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "CT",
            "license": "27137",
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CT",
            "license": "027137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001271378",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0585739002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1870457",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OS2228",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00127137800",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "010027137CT01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "020138",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "216970",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorraine Greenfield, LPC
• Kristin Greenhalgh
• Daniel Greenstein, M.S.
• Griffin Consulting Services, LLC
• Caitlin Grimaldi, MAO
• Brian M Grosberg, MD
• Miela Joanna Gruber, N.D.
• Krystine Gryglewicz
• Ronnie Anthony Guidice, D.D.S.
• Arshpreet Singh Gulati, MD

• Allergy Physician in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Allergy Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.