NPIMap

Organization Active NPI

DRS. Joanne and Tem Gronquist, Inc.

  • Optometrist
  • Santa Barbara, CA
National Provider Identifier
1902488893
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DRS. JOANNE AND TEM GRONQUIST, INC.
Practice address
1805 State St Ste B
Santa Barbara, CA 93101-8417
Phone
(805) 569-1504
Fax
(805) 569-8707
NPI assigned
Apr 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Authorized official

Name
Dr. Joanne Gronquist, ODNPI 1518938117
Title
Optometrist/ Owner
Phone
(805) 569-1504

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1805 State St Ste B
Santa Barbara, CA 93101-8417

Mailing address

1805 State St Ste B
Santa Barbara, CA 93101-8417
Phone (805) 569-1504

Other names 1

  • Dr.Joanne Gronquist Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210928001311 CA Part B Supplier - Clinic/Group Practice 3971900341 Receives reassigned benefits from 3 practitioners
Practice locations: Santa Barbara, CA

National Provider Directory

National Provider Directory

Locations

1805 State St
Ste B
Santa Barbara, CA 93101
Phone (805) 569-1504

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1902488893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 STATE ST STE B",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931018417",
            "telephone_number": "805-569-1504",
            "fax_number": "805-569-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 STATE ST STE B",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931018417",
            "telephone_number": "805-569-1504",
            "fax_number": "805-569-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. JOANNE AND TEM GRONQUIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "GRONQUIST",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "OPTOMETRIST/ OWNER",
        "authorized_official_telephone_number": "805-569-1504",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr.Joanne Gronquist",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Dr.Joanne Gronquist",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.