Individual provider Active NPI

Grenville Rio-John Fernandes, MD

  • Physical Medicine & Rehabilitation Physician
  • Indianapolis, IN
National Provider Identifier
1891157046
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
01084046A Issued in IN
Practice address
340 W 10TH St # Fs5100
Indianapolis, IN 46202-3082
Phone
(317) 948-0200
NPI assigned
Mar 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 01084046A IN Primary

Addresses

Primary practice location

340 W 10TH St # Fs5100
Indianapolis, IN 46202-3082

Mailing address

340 W 10TH St # Fs5100
Indianapolis, IN 46202-3082

Other practice location 1

4141 Shore Dr
Indianapolis, IN 46254-2607
Phone (317) 329-2000

Other practice location 2

UTMC PM&R Residency Program
3000 Arlington Ave, MS 1086
Toledo, OH 43614-2595
Phone (419) 383-5090

Other practice location 3

Rehabilitation Hospital of Northwest Ohio
1455 W Medical Loop
Toledo, OH 43614-8015
Phone (419) 214-6292

Other identifiers 1

IdentifierTypeStateIssuer
300039070MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gfernandes@direct.iuhealth.org Direct
Direct Messaging Address gfernandes@directaddress.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20200619000310 IN Practitioner - Physical Medicine and Rehabilitation 6204127863 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
  • Rehabilitation Hospital of Indiana Inc Inpatient rehabilitation facility, Indianapolis, IN, CCN 153028

Merit-based Incentive Payment System (MIPS)

Final score
97.51 of 100Reported as group
Quality
84.51
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01084046AINMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
University Family Physicians, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Rehabilitation Associates of in PC Physical Medicine & Rehabilitation CurrentSince Aug 5, 2020 Accepting new patients
University Family Physicians, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Major Hospital Past Accepting new patients
University of Toledo Physicians LLC Physical Medicine & Rehabilitation Past Accepting new patients

Locations

7216 Solutions Ctr
Chicago, IL 60677

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

4141 Shore Dr
Indianapolis, IN 46254
Phone (317) 329-2000

6330 E 75th St
Ste 110
Indianapolis, IN 46250
Phone (317) 588-7130

Interoperability endpoints

  • Direct secure messaging: gfernandes@directaddress.net
  • Direct secure messaging: gfernandes@direct.iuhealth.org

Organizations & group practices 6

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": "1459036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1891157046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W 10TH ST # FS5100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W 10TH ST # FS5100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023082",
            "telephone_number": "317-948-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4141 Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462542607",
            "country_code": "US",
            "telephone_number": "317-329-2000",
            "fax_number": "317-329-2531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "UTMC PM&R Residency Program",
            "address_2": "3000 Arlington Ave, MS 1086",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436142595",
            "country_code": "US",
            "telephone_number": "419-383-5090",
            "fax_number": "419-383-3596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Rehabilitation Hospital of Northwest Ohio",
            "address_2": "1455 W Medical Loop",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436148015",
            "country_code": "US",
            "telephone_number": "419-214-6292",
            "fax_number": "419-214-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "GRENVILLE",
        "middle_name": "RIO-JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-27",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01084046A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300039070",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gfernandes@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4141 Shore Dr",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462542607",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gfernandes@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6330 E 75th St Ste 110",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.