Edwin T McGroarty, M.D.
Individual provider Active NPI Family Medicine Physician · Avalon, CA
NPI 1891767299 · NPPES record last updated Feb 28, 2023
Key facts
- NPI
- 1891767299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 145912 (CA)
- Practice address
- 100 Falls Canyon Road
Avalon, CA 90704-1563 - Phone
- (310) 510-0096
- Fax
- (310) 510-2938
- NPI assigned
- Feb 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Cincinnati College of Medicine, 1997
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Avalon Medical Development Corporation
McKenzie County Healthcare Systems Inc
Practice addresses (Care Compare)
100 Falls Canyon Rd
Avalon, CA 90704-2990
Phone (310) 510-0700
1542 16TH St W
Williston, ND 58801-3888
Phone (701) 577-6337
3 4TH St E
Williston, ND 58801-5350
Phone (701) 577-6337
509 16TH St NE
Watford City, ND 58854-7628
Phone (701) 444-7814
709 4TH Ave NE
Watford City, ND 58854-7628
Phone (701) 842-3000
Hospital & facility affiliations
- CHI Health at Home - HHA
- McKenzie County Healthcare Systems Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180302002202 | CA | Practitioner - Family Practice | 2860442514 | Reassigns benefits to 2 organizations |
| I20240702004527 | ND | Practitioner - Family Practice | 2860442514 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 145912 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seneca Healthcare District | Current | Accepting new patients | |
| Avalon Medical Development Corporation | Current |
Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Current |
Accepting new patients | |
| Seneca Healthcare District | Current |
Accepting new patients | |
| Seneca Healthcare District | Current |
Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Family Medicine | Current | Accepting new patients |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| Artesia General Hospital | Past | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| Casa Grande Emergency Physicians PLLC | Emergency Medicine | Past | Accepting new patients |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| Az Corridor Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
Locations
100 Falls Canyon Rd
Avalon, CA 90704
Phone (310) 510-0700
1002 18th Ave SE
Ste C
Minot, ND 58701
Phone (701) 857-6010
525 N Main St
Watford City, ND 58854
Phone (701) 842-3771
709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331
1542 16th St W
Ste 300
Williston, ND 58801
Phone (701) 572-2470
Interoperability endpoints
- edwin.mcgroarty.1@14021.direct.athenahealth.com
- edwin.mcgroarty@khindirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 145912 | CA | Yes |
Addresses
Primary practice location
100 Falls Canyon Road
Avalon, CA 90704-1563
Mailing address
P.O. Box 1563
Avalon, CA 90704-1563
Phone (310) 510-0096
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM302555 | Other | NM | MEDICARE PTAN |
Other providers in Avalon, CA
- Brian J Kuhn
- Natalie Latshaw
- Leo'S Catalina Drug Store Inc.
- Martinez Chiropractic, Inc.
- Joseph Louis Martinez
- Andrea Olson Diaz
- Bill Harold Paige
- Karla Marguerite Perisho
- Susan L Ponce
- Larry E Reimer
All providers in Avalon, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.