Gerald E Gronborg, DPM
Individual provider Active NPI Primary Podiatric Medicine Podiatrist · MC Connellsburg, PA
NPI 1902884950 · NPPES record last updated Aug 22, 2025
Key facts
- NPI
- 1902884950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Podiatric Medicine Podiatrist 213EP1101X
- License
- SC003442L (PA)
- Practice address
- 214 Peach Orchard Rd
MC Connellsburg, PA 17233-8559 - Phone
- (717) 485-3155
- Fax
- (717) 485-6105
- NPI assigned
- Jan 9, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fulton County Medical Center
Practice addresses (Care Compare)
214 Peach Orchard Rd
MC Connellsburg, PA 17233-8559
Phone 71748531556375
Hospital & facility affiliations
- Fulton County Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 16 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100728000028 | PA | Practitioner - Podiatry | 7810020815 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC003442L | PA | MD | Primary Podiatric Medicine Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Podiatry LLC | Podiatrist | Current |
Accepting new patients |
| Fulton County Medical Center | Current |
Accepting new patients | |
| Fulton County Medical Center | Current |
Accepting new patients | |
| Gary a Raymond, DPM, PC | Podiatrist | Past | Accepting new patients |
| Fulton County Medical Center | Past | Accepting new patients | |
| Fulton County Medical Center | Past | Accepting new patients | |
| Windber Hospital, Inc. | Past | Accepting new patients |
Locations
914 S 12th St
Altoona, PA 16602
Phone 81420123091104
265 Hospital Dr
Everett, PA 15537
Phone (814) 310-2438
350 Birch St
Ste 100
Patton, PA 16668
Phone 81420123091142
Interoperability endpoints
- geraldgronborg@fcmcpa.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Podiatrist | 213ER0200X | SC003442L | PA | |
| Podiatrist | 213E00000X | SC003442L | PA | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | SC003442L | PA | |
| Primary Podiatric Medicine Podiatrist | 213EP1101X | SC003442L | PA | Yes |
Addresses
Primary practice location
214 Peach Orchard Rd
MC Connellsburg, PA 17233-8559
Mailing address
214 Peach Orchard Rd
MC Connellsburg, PA 17233-8559
Phone (717) 485-3155
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0857830000 | Other | PA | PPO PROGRAM INDEPENDENCE |
| 5166987 | Other | PA | PPNI |
| 7318023 | Other | PA | MAMSI |
| 0012762560012 | Medicaid | PA | |
| 000706203 | Other | PA | KEYSTONE HEALTH PLAN |
| 21128765012 | Other | PA | BEECH STREET |
| 0012762560010 | Medicaid | PA | |
| 826758 | Other | PA | BLUE SHIELD GROUP |
| 2805196 | Other | PA | AETNA HMO QPOS |
| 480013965 | Other | PA | RR MEDICARE INDIVIDUAL |
| 1022107 | Other | PA | GATEWAY |
| 200069 | Other | PA | UPMC |
| CC2226 | Other | PA | RR MEDICARE GROUP |
| P 54229714 | Other | PA | MULTIPLAN |
| 000000060525 | Other | PA | UNISON |
| GR706203 | Other | PA | BLUE SHIELD INDIVIDUAL |
| 0012762560009 | Medicaid | PA |
Other providers in MC Connellsburg, PA
- Gaudenzia
- Erin Camille Glenn
- Elizabeth T. Gotwals
- Cody Grace
- Great Cove Integrative Medicine LLC
- Lavan Harris
- Deann Laura Hawkins
- Dameion Ray Helfrick
- Jenny Hershey
- Stephen Anthony Hoffman
All providers in MC Connellsburg, PA · Primary Podiatric Medicine Podiatrist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2025. 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.