Individual provider Active NPI

Kevin Groudan, MD

  • Gastroenterology Physician
  • New York, NY
National Provider Identifier
1841750429
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
330535 Issued in NY
Practice address
518 E 20TH St
New York, NY 10009-8330
Phone
(646) 682-3555
NPI assigned
Mar 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 330535 NY Primary

Addresses

Primary practice location

518 E 20TH St
New York, NY 10009-8330

Mailing address

518 E 20TH St
New York, NY 10009-8330
Phone (646) 682-3555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20250717000009 NY Practitioner - Gastroenterology 1658606587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

518 E 20TH St
New York, NY 10009-8330
Phone (646) 682-3555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy17
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
330535NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 15, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 15, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

518 E 20th St
New York, NY 10009
Phone (646) 682-3555

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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 2

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1841750429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 E 20TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100098330",
            "telephone_number": "646-682-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 E 20TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100098330",
            "telephone_number": "646-682-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROUDAN",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "330535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.