Active NPI
David A Grundy, MD
- Emergency Medicine Physician
- Santa Rosa, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- C55843
- Practice address
- 1165 Montgomery Dr
Santa Rosa, CA 95405-4801 - Phone
- (707) 546-3210
- NPI assigned
- Jun 6, 2006
- Last updated
- Mar 26, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 35076862 | OH | |
| Emergency Medicine Physician | 207P00000X | C55843 | CA | Primary |
Addresses
Primary practice location
1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Mailing address
1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2350343 | Medicaid | OH | |
| P00273888 | Other | RAILROAD MEDICARE | |
| 000000363780 | Other | OH | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9449 San Fernando Rd
Sun Valley, CA 91352-1421
Phone (818) 767-3310
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55843 | CA | MD | Dentist |
| C55843 | CA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Erx Plus Professional Corporation | Emergency Medicine | Current | Accepting new patients |
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Team Physicians of California Medical Group Inc | Emergency Medicine | Current | Accepting new patients |
| Nes Western Group, a Professional Corporation | Emergency Medicine | Current | Accepting new patients |
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Nes Western Group, a Professional Corporation | Emergency Medicine | Current | Accepting new patients |
| Cep America-California | Emergency Medicine | Current | Accepting new patients |
| Premier Health Partners | Emergency Medicine | Current | Accepting new patients |
| Foothill Emergency Medical Associates, Inc | Emergency Medicine | Current | Accepting new patients |
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Erx Plus Professional Corporation | Emergency Medicine | Past | Accepting new patients |
| Vanguard Medical | Emergency Medicine | Past | Accepting new patients |
| University of Cincinnati Physicians Company, LLC | Past | Accepting new patients | |
| Middletown Emergency Physicians, Inc. | Emergency Medicine | Past | Accepting new patients |
Locations
250 N 1st St
Blythe, CA 92225
Phone (760) 321-5123
2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000
1900 Sullivan Ave
Daly City, CA 94015
Phone (650) 991-6503
2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229
975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575
5189 Hospital Rd
Mariposa, CA 95338
Phone (209) 966-3631
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125
600 Marine Blvd
Moss Beach, CA 94038
Phone (650) 563-7100
465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886
170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536
15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051
222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222
9449 San Fernando Rd
Sun Valley, CA 91352
Phone (818) 252-2184
Organizations & group practices 16
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.
-
- Emergency Medicine Physician
- Blythe, CA
- NPI 1609170232
-
- Emergency Medicine Physician
- Mariposa, CA
- NPI 1336508407
-
- Emergency Medicine Physician
- Daly City, CA
- NPI 1659683720
-
- Emergency Medicine Physician
- Porterville, CA
- NPI 1487125019
-
- Emergency Medicine Physician
- Delano, CA
- NPI 1447288345
-
- Emergency Medicine Physician
- Santa Rosa, CA
- NPI 1033152350
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
-
- Emergency Medicine Physician
- Hayward, CA
- NPI 1588249569
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Mariposa, CA
- NPI 1184662652
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458950400000",
"number": "1902845597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1165 MONTGOMERY DR",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954054801",
"telephone_number": "707-546-3210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1165 MONTGOMERY DR",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954054801",
"telephone_number": "707-546-3210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUNDY",
"first_name": "DAVID",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2016-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OH",
"license": "35076862",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "C55843",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2350343",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00273888",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000363780",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.