Robert E Grondahl, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

01059882 Issued in IN

Practice address

1111 Ronald Reagan Pkwy Ste 1400
Avon, IN 46123-7085

Phone

(317) 217-2777

Fax

(317) 217-2775

NPI assigned

Oct 2, 2006

Last updated

Jun 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

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

Specialty

Obstetrics/Gynecology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mainehealth Waldo Hospital Hospital, Belfast, ME, CCN 201312
• Mainehealth Pen Bay Hospital Hospital, Rockport, ME, CCN 200063

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rgrondahl260234@direct.mmc.mainehealth.org

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.

• Mainehealth

  dba Mainehealth Behavioral Health

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment NPD
• Mainehealth

  dba MaineHealth Waldo Hospital

  • Critical Access Hospital
  • Belfast, ME
  • NPI 1841397932
  Medicare reassignment NPD
• Mainehealth

  dba MaineHealth Pharmacy Brighton Ave

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  dba MaineHealth Waldo Hospital

  • Critical Access Hospital
  • Belfast, ME
  • NPI 1265912075
  NPD
• Mainehealth

  dba MaineHealth Medical Group-Primary Care

  • Clinic/Center
  • Portland, ME
  • NPI 1487346722
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mainehealth

  dba MaineHealth Waldo Hospital

  • Critical Access Hospital
  • Belfast, ME
  • NPI 1841397932
  Care Compare affiliation
• Mainehealth

  dba MaineHealth Pen Bay Hospital

  • General Acute Care Hospital
  • Rockport, ME
  • NPI 1982645305
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1922191816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 RONALD REAGAN PKWY STE C1400",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237085",
            "telephone_number": "317-217-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 RONALD REAGAN PKWY STE 1400",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237085",
            "telephone_number": "317-217-2777",
            "fax_number": "317-217-2775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Fahy St Ste 108",
            "address_purpose": "LOCATION",
            "city": "Belfast",
            "state": "ME",
            "postal_code": "049156029",
            "country_code": "US",
            "telephone_number": "207-505-4345",
            "fax_number": "207-505-4349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRONDAHL",
        "first_name": "ROBERT",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01059882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200525570",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Christine Gregory, RN
• Kathy Gretton, FNP
• Melissa Grimes, FNP
• Daniel Paul Grinberg, LMSW, LCSW
• Amanda Melissa Gripe, M.D.
• Deanna Lorraine Gross, RBT
• Dylan Grubbs, LMCH-A
• Rebecca R Guanajuato, NP-C
• Brynn Aelani Gude
• Natasha R Guffey, LSW

• Obstetrics & Gynecology Physician in Avon, IN
• Providers in Avon, IN by specialty
• Obstetrics & Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.

Verify at the official NPI Registry.