David Grise, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

017362 Issued in CT

Practice address

27 Sycamore St
Ste 100, Prime Healthcare
Glastonbury, CT 06033-2223

Phone

(860) 659-0581

Fax

(860) 652-3077

NPI assigned

Dec 23, 2005

Last updated

Mar 7, 2023By 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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CT

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

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.

• Prime Healthcare, PC

  • Internal Medicine Physician
  • Wethersfield, CT
  • NPI 1184819302
  Medicare reassignment NPD
• Prime Healthcare (Sleep Lab)

  • Sleep Disorder Diagnostic Clinic/Center
  • Wethersfield, CT
  • NPI 1184832354
  NPD

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1982681599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JORDAN LN",
            "address_2": "PRIME HEALTHCARE",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091278",
            "telephone_number": "860-263-0253",
            "fax_number": "860-263-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 SYCAMORE ST",
            "address_2": "STE 100, PRIME HEALTHCARE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332223",
            "telephone_number": "860-659-0581",
            "fax_number": "860-652-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISE",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "017362",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "017362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010017362CT01",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001173624",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "017362",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Gresh, FNP-BC
• Susan E. Grey, APRN
• Elizabeth Grieder, MA
• Karin Anne Griffin, LCSW
• Stephen N Grimaldi, DO
• Roseann Groh
• Growing Well, LLC
• Ilene Grueneberg, PH.D.
• Cynthia Alice Gruss, ATC
• Christina M Guida, OTR

• Pulmonary Disease Physician in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Pulmonary Disease Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.