Kenneth M Grundfast (NPI# 1336101054, PAC ID# 0446259725) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1336101054 |
| PAC ID by PECOS | 0446259725 |
| Professional Enrollment ID | I20110620000229 |
| Full Name | Kenneth M Grundfast |
| Organization Legal Name | BUMC OTOLARYNGOLOGIC FOUNDATION INC |
| Address |
830 Harrison Ave Boston MA 02118-2905 |
| Phone Number | 6176388124 |
| Gender | M |
| Medical School | STATE UNIVERSITY OF NEW YORK HEALTH SCIENCE CENTER OF SYRACUSE |
| Graduation Year | 1969 |
| Primary Specialty | OTOLARYNGOLOGY |
| Group Practice PAC ID | 2163409400 |
| Number of Group Practice Members | 23 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 220075 | MASSACHUSETTS EYE AND EAR INFIRMARY - |
| 220031 | BOSTON MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 243 Charles St, Boston, MA 02114-3002 | 6175237900 | MASSACHUSETTS EYE AND EAR ASSOCIATES, INC |
| 830 Harrison Ave, Boston, MA 02118-2905 | 6176388124 | BUMC OTOLARYNGOLOGIC FOUNDATION INC |
| Organization Legal Name | BUMC OTOLARYNGOLOGIC FOUNDATION INC |
| Physicians | 25 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anand K Devaiah | Otolaryngology | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Jacob P Noordzij | Otolaryngology | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Peter C Weber | Otolaryngology | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Susan Griever | Nurse Practitioner | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Jessica R Levi | Otolaryngology | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Christopher David Brook | Otolaryngology | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Daniel Faden | Otolaryngology | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Jessica Whitehouse | Physician Assistant | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Elizabeth Anne Blasberg | Otolaryngology | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Lauren Wood Tracy | Otolaryngology | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Street Address |
830 HARRISON AVE |
| City | BOSTON |
| State | MA |
| Zip | 02118-2905 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Emily Caroline Johnson | Nurse Practitioner | Evans Medical Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Ilse M Castro Aragon | Diagnostic Radiology | Boston University Medical Center Radiologists, Inc. | 830 Harrison Ave, Boston, MA 02118-2905 |
| Anand K Devaiah | Otolaryngology | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Jacob P Noordzij | Otolaryngology | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Andreea M Negroiu | Medical Oncology | Evans Medical Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Ashley Davidoff | Diagnostic Radiology | Boston University Medical Center Radiologists, Inc. | 830 Harrison Ave, Boston, MA 02118-2905 |
| Peter C Weber | Otolaryngology | Bumc Otolaryngologic Foundation Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Christina A. Lebedis | Diagnostic Radiology | Boston University Medical Center Radiologists, Inc. | 830 Harrison Ave, Boston, MA 02118-2905 |
| Jesse C Rayan | Diagnostic Radiology | Boston University Medical Center Radiologists, Inc. | 830 Harrison Ave, Boston, MA 02118-2905 |
| Jacklyn Guill | Physician Assistant | Boston University Radiation Oncology Inc | 830 Harrison Ave, Boston, MA 02118-2905 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren M Nentwich | Emergency Medicine | Boston Emergency Physician Foundation Inc | 1 Boston Med Ctre Pl, Boston, MA 02118 |
| Sancho Maulion | Physical Therapy | 801 B Tremont St, Boston, MA 02118-1054 | |
| Amanda Kate Turcotte | Optometry | L Martin Eye Incorporated | 681 Tremont St, Boston, MA 02118-1281 |
| Susan M Haskell | Clinical Social Worker | 135 W Concord St, Boston, MA 02118-1507 | |
| Sarah Stipho | Oral Surgery | Joseph P Nore Dds Inc | 586 Tremont St, Boston, MA 02118-1659 |
| T.lee Shostack | Clinical Social Worker | South End Community Health Center Inc | 1601 Washington St, Boston, MA 02118-1951 |
| Nichole T Daly | Registered Dietitian Or Nutrition Professional | South End Community Health Center Inc | 1601 Washington St, Boston, MA 02118-1951 |
| Deanne Dworski-riggs | Clinical Social Worker | South End Community Health Center Inc | 1601 Washington St, Boston, MA 02118-1951 |
| Maya Mauch | Family Medicine | South End Community Health Center Inc | 1601 Washington St, Boston, MA 02118-1951 |
| Glennon J O Grady | Family Medicine | South End Community Health Center Inc | 1601 Washington St, Boston, MA 02118-1951 |
| Find all physicians in zip 02118 | |||
| City | BOSTON |
| Zip Code | 02118 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | BOSTON + OTOLARYNGOLOGY |
Please comment or provide details below to improve the information on Kenneth M Grundfast.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.