Individual provider Active NPI

Dennis Patrick Grusenmeyer, MD

  • Hospitalist Physician
  • Keene, NH
National Provider Identifier
1871568113
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
20152 Issued in NH
Practice address
580 Court St
Keene, NH 03431
Phone
(603) 354-5400
NPI assigned
Feb 21, 2006
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2017-0031 NC
Internal Medicine Physician 207R00000X MD60983758 WA
Internal Medicine Physician 207R00000X 0101235353 VA
Internal Medicine Physician 207R00000X MD191698 OR
Hospitalist Physician 208M00000X MD60983758 WA
Hospitalist Physician 208M00000X 2017-0031 NC
Hospitalist Physician 208M00000X 20152 NH Primary

Addresses

Primary practice location

580 Court St
Keene, NH 03431

Mailing address

PO Box 810
Hanover, NH 03755-0810
Phone (603) 650-8050

Other practice location 1

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-8407

Other practice location 2

3241 Western Branch Blvd
Chesapeake, VA 23321-5260
Phone (757) 686-3508

Other practice location 3

888 Swift Blvd
Richland, WA 99352-3514
Phone (509) 942-2648

Other practice location 4

509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 213-4411

Other practice location 5

590 Court St
Keene, NH 03431-1719
Phone (603) 354-5400

Other practice location 6

3043 NE 28th St
Lincoln City, OR 97367-4518
Phone (541) 994-3661

Other identifiers 1

IdentifierTypeStateIssuer
010014727MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgrusenmeyeragency269023@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, OR2 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
I20180925000387 NC Practitioner - Internal MedicinePractitioner - Hospitalist 0648299644
I20190621002037 OR Practitioner - Internal MedicinePractitioner - Hospitalist 0648299644 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
University of Cincinnati College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

24800 SE Stark St
Gresham, OR 97030-3378
Phone (503) 413-8988

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD191698ORMDInternal Medicine Physician
0101235353VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Silverton Health CurrentSince Mar 20, 2020 Accepting new patients
Albany General Hospital Current Accepting new patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
Silverton Health Current Accepting new patients
Legacy Clinics LLC CurrentSince Dec 20, 2019 Accepting new patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Silverton Health CurrentSince Mar 20, 2020 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Dec 20, 2019 Accepting new patients

Locations

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

Interoperability endpoints

  • Direct secure messaging: dgrusenmeyer506394@direct.uvmhealth.org
  • Direct secure messaging: dgrusenmeyeragency269023@samhealth.direct-ci.com
  • Direct secure messaging: vrhdgruse@yourcarecommunity.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1871568113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037550810",
            "telephone_number": "603-650-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "03431",
            "telephone_number": "603-354-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 N Gantenbein Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271623",
            "country_code": "US",
            "telephone_number": "503-413-8407",
            "fax_number": "503-413-6951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3241 Western Branch Blvd",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233215260",
            "country_code": "US",
            "telephone_number": "757-686-3508",
            "fax_number": "757-686-0541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "888 Swift Blvd",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523514",
            "country_code": "US",
            "telephone_number": "509-942-2648",
            "fax_number": "509-942-2812",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "509 Biltmore Ave",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288014601",
            "country_code": "US",
            "telephone_number": "828-213-4411",
            "fax_number": "828-213-0275",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "590 Court St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034311719",
            "country_code": "US",
            "telephone_number": "603-354-5400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3043 NE 28th St",
            "address_purpose": "LOCATION",
            "city": "Lincoln City",
            "state": "OR",
            "postal_code": "973674518",
            "country_code": "US",
            "telephone_number": "541-994-3661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUSENMEYER",
        "first_name": "DENNIS",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2017-0031",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60983758",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101235353",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD191698",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD60983758",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2017-0031",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NH",
            "license": "20152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010014727",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgrusenmeyeragency269023@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3043 NE 28th St",
            "city": "Lincoln City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973674518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.