NPIMap

Individual provider Active NPI

Dougals Reid Grogan Jr., M.D.

  • Family Medicine Physician
  • Brockton, MA
National Provider Identifier
1962516757
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47811 Issued in MA
Practice address
111 Torrey St
Brockton, MA 02301-4800
Phone
(508) 588-1200
Fax
(508) 941-0497
NPI assigned
Aug 18, 2006
Last updated
May 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 47811 MA Primary

Addresses

Primary practice location

111 Torrey St
Brockton, MA 02301-4800

Mailing address

111 Torrey St
Brockton, MA 02301-4800
Phone (508) 588-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050324000853 MA Practitioner - Family Practice 2668374711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bethel Medical Group PCGroup PAC ID 4688576721, 5 clinicians

Practice addresses (Care Compare)

111 Torrey St
Brockton, MA 02301-4800
Phone (508) 588-1200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47811MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bethel Medical Group PC Family Medicine CurrentSince Jun 3, 1981 Accepting new patients
Trinity Family Medicine Family Medicine Past Accepting new patients

Locations

111 Torrey St
Brockton, MA 02301
Phone (508) 584-5190

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/111/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/2020/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 12

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1962516757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014800",
            "telephone_number": "508-588-1200",
            "fax_number": "508-941-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014800",
            "telephone_number": "508-588-1200",
            "fax_number": "508-941-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROGAN",
        "first_name": "DOUGALS",
        "middle_name": "REID",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "47811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.