Individual provider Active NPI

David A Grundy, MD

  • Emergency Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1902845597
Registry record updated Mar 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C55843 Issued in CA
Practice address
1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone
(707) 546-3210
NPI assigned
Jun 6, 2006
Last updated
Mar 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2350343MedicaidOH
P00273888OtherRAILROAD MEDICARE
000000363780OtherOHBCBS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150903000258 CA Practitioner - Emergency Medicine 6608805841 Reassigns benefits to 8 organizations

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
Premier Health PartnersGroup PAC ID 1759564396, 20 clinicians

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

LicenseStateTypeSpecialty
55843CAMDDentist
C55843CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Erx Plus Professional Corporation Emergency Medicine CurrentSince Feb 1, 2025 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Sep 10, 2016 Accepting new patients
Nes Western Group, a Professional Corporation Emergency Medicine CurrentSince Dec 1, 2022 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Nes Western Group, a Professional Corporation Emergency Medicine CurrentSince Dec 1, 2022 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
Premier Health Partners Emergency Medicine CurrentSince Sep 29, 2025 Accepting new patients
Foothill Emergency Medical Associates, Inc Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Apr 1, 2024 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.

View all 16

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": "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

Verify at the official NPI Registry.