Active NPI
Elaine W Grunberg, M.D.
- Internal Medicine Physician
- Lexington, MA
National Provider Identifier
1922249218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 60512
- Practice address
- 11 Locust Ave
Lexington, MA 02421-5803 - Phone
- (781) 674-1343
- NPI assigned
- Mar 16, 2009
- Last updated
- Mar 16, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 60512 | MA | Primary |
Addresses
Primary practice location
11 Locust Ave
Lexington, MA 02421-5803
Mailing address
11 Locust Ave
Lexington, MA 02421-5803
Phone (781) 674-1343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60512 | MA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237161600000",
"number": "1922249218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 LOCUST AVE",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024215803",
"telephone_number": "781-674-1343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 LOCUST AVE",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024215803",
"telephone_number": "781-674-1343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUNBERG",
"first_name": "ELAINE",
"middle_name": "W",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-16",
"last_updated": "2009-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "60512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.