SHELLY STEPHENS GROENENDYK MD
NPI 1083060917
Anesthesiology in Port Jefferson, NY

Q: What is Shelly Groenendyk's NPI number?

The NPI number for Shelly Groenendyk is 1083060917. It was assigned to this individual provider in the NPPES registry on May 10, 2016.

Q: What is Shelly Groenendyk's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Q: When was this NPI record last updated?

The NPPES record for Shelly Groenendyk was last updated on November 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 10, 2016PECOS EnrolledAccepts Medicare Assignment

97.12/100

CMS Quality Rating

75 N COUNTRY RD, PORT JEFFERSON, NY 11777(516) 382-7399 Get Directions Write a Review

NPPES record last updated: November 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 24, 2023, Nov 22, 2021, Sep 24, 2021 and 5 more (8 updates tracked since 2016).

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About Shelly Stephens Groenendyk Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHELLY STEPHENS GROENENDYK MD (NPI 1083060917) is an individual anesthesiology provider in Port Jefferson, New York, licensed in New York (329018) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS, is affiliated with John T Mather Memorial Hospital Of Port Jefferson, and maintains a secondary practice location in Nashville.

NPPES Registry Identity

NPI1083060917

Entity TypeIndividualFemale

Primary Taxonomy207L00000X

Provider Legal NameSHELLY STEPHENS GROENENDYKCredential: MD

Location Address75 N COUNTRY RDPort Jefferson, NY 11777-2190

Mailing Address25 Rocky Hill RdMount Sinai, NY 11766-1213 · (801) 205-1033

Phone(516) 382-7399

Sole ProprietorNo

Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 2016

Enumeration DateMay 10, 2016

Last NPPES UpdateNovember 3, 20248 updates tracked since enumeration

NPPES CertifiedNovember 3, 2024

✔ NPI 1083060917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians

Taxonomy Code207L00000X

Licenses✔ Licensed in NY · 329018✔ Licensed in UT · 10516430-1205✔ Licensed in TN · 63603

Definition

An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.

75 N COUNTRY RD, Port Jefferson, NY 11777

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Secondary Practice Location 1

Location 13601 The Vanderbilt ClinicNashville, TN 37232-0001 · Phone (615) 322-3000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shelly Stephens Groenendyk Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6709177090

PECOS Enrollment IDI20241217002834

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731

This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.

16 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

John T Mather Memorial Hospital Of Port Jefferson

Acute Care Hospitals · Port Jefferson, NY

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330185

Location75 North Country RoadPort Jefferson, NY 11777 · Suffolk County

Emergency services

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.12/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

85.64

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUSTINA CATHERINE MELLONE DO

Student in an Organized Health Care Education/Training Program