Individual provider Active NPI

Benjamin J Grudinskas Jr., MD

  • Anesthesiology Physician
  • Manchester, NH
National Provider Identifier
1922006253
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
231186 Issued in MA
Practice address
1 Elliot Way
Manchester, NH 03103-3502
Phone
(603) 669-5300
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 231186 MA Primary

Addresses

Primary practice location

1 Elliot Way
Manchester, NH 03103-3502

Mailing address

1 Elliot Way
Suite 200
Manchester, NH 03103-3502
Phone (603) 623-4640

Other practice location 1

100 Hitchcock Way
Manchester, NH 03104-4125
Phone (603) 695-2500

Other identifiers 1

IdentifierTypeStateIssuer
30204516MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20041104000412 NH Practitioner - Anesthesiology 4880657501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loyola University of Chicago, Stritch School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amoskeag Anesthesia PLLCGroup PAC ID 1759375983, 165 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 663-2431

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
231186MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amoskeag Anesthesia, PLLC Anesthesiology CurrentSince Jan 19, 2007 Accepting new patients
Anesthesia Care Group PC Anesthesiology Past Accepting new patients

Locations

4 Hawthorne Dr
Bedford, NH 03110
Phone (603) 472-8888

11 Washington Pl
Bedford, NH 03110
Phone (603) 622-3670

580 Court St
Keene, NH 03431
Phone (603) 354-5454

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

1 Elliot Way
Ste 200
Manchester, NH 03103
Phone (603) 623-4640

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

23 Keewaydin Dr
Ste 100
Salem, NH 03079
Phone (603) 386-0272

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1922006253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "address_2": "SUITE 200",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-623-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-669-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Hitchcock Way",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031044125",
            "country_code": "US",
            "telephone_number": "603-695-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUDINSKAS",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "231186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30204516",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.