Samuel Robert Grodofsky, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD451221 Issued in PA

Practice address

1 Bala Ave Ste 418
Bala Cynwyd, PA 19004-3207

Phone

(215) 366-2803

Fax

(267) 337-7950

NPI assigned

Apr 21, 2010

Reactivated

Apr 5, 2019

Last updated

Dec 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

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 2

Specialty

Anesthesiology

Education

Jefferson Medical College of Thomas Jefferson University, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Philadelphia Smart Pain and Wellness PCGroup PAC ID 6709163371, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Philadelphia Smart Pain & Wellness, P.C.

  • Pain Medicine (Anesthesiology) Physician
  • Bala Cynwyd, PA
  • NPI 1093257776
  Medicare reassignment Care Compare group Authorized official
• Fox Chase Pain Management Associates, PC

  • Specialist
  • Trevose, PA
  • NPI 1881649416

  NJ

  Medicare reassignment NPD
• Temple Physicians Inc

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1942444088
  Medicare reassignment NPD
• Temple Physician Inc.

  • Internal Medicine Physician
  • Feasterville Trevose, PA
  • NPI 1174497366
  NPD
• Temple Physicians Inc.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1659422996
  NPD
• Ferrara Neurosurgical Associates LTD

  • Specialist
  • Jenkintown, PA
  • NPI 1316993637
  NPD (past)

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1932426566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BALA AVE STE 418",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043207",
            "telephone_number": "215-366-2803",
            "fax_number": "267-337-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BALA AVE STE 418",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043207",
            "telephone_number": "215-366-2803",
            "fax_number": "267-337-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODOFSKY",
        "first_name": "SAMUEL",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-21",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "deactivation_date": "2019-03-23",
        "reactivation_date": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD451221",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "MD451221",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie Greene, LMT, CMMP
• Tierney Greene, LSW
• Greenlee Home Care Services
• Mark Greenwood, MPT
• Mary Elizabeth Griffin, DO
• Karen Groom
• Melissa Gross
• Sheldon Warren Gross, M.D.
• Leah Grossman
• Michael R. Grossman, DPM

• Anesthesiology Physician in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Anesthesiology Physician in Pennsylvania

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