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TOMASZ K GROCHOWALSKI M.D.
NPI 1265495980
Internal Medicine in South Amboy, NJ

Active since April 11, 2006PECOS EnrolledAccepts Medicare Assignment
94.95/100
CMS Quality Rating
2045 STATE ROUTE 35, SUITE 202, SOUTH AMBOY, NJ 08879(732) 721-5511(732) 721-2007 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tomasz K Grochowalski M.d. NPPES

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

TOMASZ K GROCHOWALSKI M.D. (NPI 1265495980) is an individual internal medicine provider in South Amboy, New Jersey, licensed in New Jersey (MA065561) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Raritan Bay Medical Center, and is a graduate of Other (1981).

NPPES Registry Identity

NPI1265495980
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameTOMASZ K GROCHOWALSKICredential: M.D.
Location Address2045 STATE ROUTE 35, SUITE 202South Amboy, NJ 08879-2069
Mailing Address2045 State Route 35, Suite 202South Amboy, NJ 08879-2069 · (732) 721-5511 · Fax (732) 721-2007
Phone(732) 721-5511
Fax(732) 721-2007
Sole ProprietorNo
Medical School CMSOtherGraduated 1981
Enumeration DateApril 11, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1265495980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · MA065561
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2045 STATE ROUTE 35, South Amboy, NJ 08879
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Other Identifiers 5

Other7164118NJ · Aetna
Other4986761NJ · Cigna
Medicare UPING67273NJ
Medicare ID-Type Unspecified009010NJ
OtherP3000218NJ · Oxford

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tomasz K Grochowalski M.d. 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 ID244220424
PECOS Enrollment IDI20040518000762
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.

Medicare Billing Reassignment

Medicare enrollment records show Tomasz Grochowalski reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Hackensack Meridian Health Medical Group - Specialty Care PC
14 mi
Surgical Critical Care
331 NEWMAN SPRINGS RD STE 220
Red Bank, NJ 07701
  • Reassigned Medicare billing, New Jersey enrollment
  • 2,844 clinicians in this Medicare group
NPI 1215989249 (732) 807-0800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
898 services322 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
36 services36 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
31 services31 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
30 services30 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
18 services18 patients
Transitional care management services for problem of at least moderate complexity 99495
Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
18 services16 patients

Hospital Affiliations CMS Care Compare 2

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

Raritan Bay Medical Center

Acute Care Hospitals · Perth Amboy, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310039
Location530 New Brunswick AvePerth Amboy, NJ 08861 · Middlesex County
Emergency services Birthing friendly

Jfk Medical Center

Acute Care Hospitals · Edison, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310108
Location65 James StreetEdison, NJ 08820 · Middlesex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08879 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

94.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality87.26
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
15 suppliers41 claims89 services$5.20 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
11 suppliers25 claims26 services$0.96 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
3 suppliers11 claims11 services$37.54 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers27 claims27 services$58.96 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier16 claims16 services$30.60 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

DR. JANET R CRAIN DMD
Dentist
2045 STATE ROUTE 35
SOUTH AMBOY, NJ 08879
Middlesex County (732) 727-5000
TOMASZ GROCHOWALSKI MD PA
Internal Medicine
2045 STATE ROUTE 35, SUITE 202
SOUTH AMBOY, NJ 08879
Middlesex County (732) 721-5511
DR. IRA M KLEMONS DDS PHD
Dentist
2045 STATE ROUTE 35
SOUTH AMBOY, NJ 08879
Middlesex County (732) 727-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tomasz Grochowalski's NPI number?

The NPI number for Tomasz Grochowalski is 1265495980. It was assigned to this individual provider in the NPPES registry on April 11, 2006.

Where is Tomasz Grochowalski located?

Tomasz Grochowalski practices at 2045 State Route 35 Suite 202, South Amboy, NJ 08879. The listed phone number is (732) 721-5511.

What is Tomasz Grochowalski's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Tomasz Grochowalski enrolled in Medicare?

Yes. Tomasz Grochowalski is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Tomasz Grochowalski's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tomasz Grochowalski reassigns Medicare benefits to Hackensack Meridian Health Medical Group - Specialty Care PC (Red Bank, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tomasz Grochowalski's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tomasz Grochowalski accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Tomasz Grochowalski as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Tomasz Grochowalski affiliated with any hospitals?

According to CMS data, Tomasz Grochowalski is affiliated with Raritan Bay Medical Center and Jfk Medical Center.

When was this NPI record last updated?

The NPPES record for Tomasz Grochowalski was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.