DR. PAUL J GRUSZKA M.D.
NPI 1295733889
Orthopaedic Surgery in Chesterton, IN

Q: What is Paul Gruszka's NPI number?

The NPI number for Paul Gruszka is 1295733889. It was assigned to this individual provider in the NPPES registry on July 8, 2005.

Q: What is Paul Gruszka's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Paul Gruszka was last updated on December 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 July 08, 2005PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

601 GATEWAY BLVD N, CHESTERTON, IN 46304(219) 921-1444(219) 921-5303 Get Directions Write a Review

NPPES record last updated: December 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 18, 2024, Mar 22, 2021, Mar 19, 2021 (3 updates tracked since 2021).

On this page

About Dr. Paul J Gruszka M.d. NPPES

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

DR. PAUL J GRUSZKA M.D. (NPI 1295733889) is an individual orthopaedic surgery provider in Chesterton, Indiana, licensed in Indiana (01039250A) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Northwest Health-la Porte, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1295733889

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. PAUL J GRUSZKACredential: M.D.

Location Address601 GATEWAY BLVD NChesterton, IN 46304-9658

Mailing Address601 Gateway Blvd NChesterton, IN 46304-9658 · (219) 921-1444 · Fax (219) 921-5303

Phone(219) 921-1444

Fax(219) 921-5303

Sole ProprietorNo

Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1986

Enumeration DateJuly 8, 2005

Last NPPES UpdateDecember 18, 20243 updates tracked since enumeration

NPPES CertifiedDecember 18, 2024

✔ NPI 1295733889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in IN · 01039250A

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

601 GATEWAY BLVD N, Chesterton, IN 46304

Open in Google Maps ↗

Secondary Practice Locations 2

Location 12501 Cumberland DrValparaiso, IN 46383-2503 · Phone (219) 921-1444

Location 23691 Willowcreek RdPortage, IN 46368-5080 · Phone (219) 921-1444

Other Identifiers 1

Medicaid100117540IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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

Dr. Paul J Gruszka 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 ID5092792440

PECOS Enrollment IDI20100112000583

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 15

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 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.

742 services350 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

625 services241 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

405 services210 patients

Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose J7321

Hyaluronan or derivatives like Hyalgan, Supartz, or Visco-3, are used in intra-articular injections for joint pain relief. They help by improving joint lubrication, reducing inflammation, and promoting tissue healing. Each dose is administered directly into the joint space.

377 services79 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

139 services94 patients

Injection, methylprednisolone acetate, 40 mg J1030

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

124 services85 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

73 services73 patients

X-ray of hip, 1 view 73501

An X-ray of the hip, 1 view, is a quick, painless test where a small amount of radiation is used to produce images of the hip joint. This helps in diagnosing conditions like arthritis or fractures. You'll be positioned so that the X-ray machine can capture the best image of your hip.

55 services40 patients

Mri scan of leg joint without contrast 73721

An MRI scan of your leg joint is a non-invasive procedure that uses magnetic fields and radio waves to create detailed images of the structures within your leg. This helps doctors diagnose or monitor conditions without using contrast dye.

38 services36 patients

Mri scan of arm joint without contrast 73221

An MRI scan of the arm joint is a non-invasive imaging procedure that uses magnetic fields and radio waves to create detailed images of the structures within your arm joint. No contrast dye is used in this process. It helps to diagnose or monitor conditions like arthritis, injuries, or infections.

28 services25 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

27 services26 patients

X-ray of finger, minimum of 2 views 73140

An X-ray of the finger involves capturing images of your finger from at least two different angles. This non-invasive procedure helps in visualizing the bones and joints, aiding in the diagnosis of fractures, infections, or other abnormalities. Minimal discomfort may be experienced.

23 services16 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

22 services14 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

22 services22 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

18 services18 patients

Hospital Affiliations CMS Care Compare 2

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

Northwest Health-La Porte

Acute Care Hospitals · La Porte, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150006

Location1331 State StreetLa Porte, IN 46350 · La Porte County

Emergency services Birthing friendly

Northwest Health - Porter

Acute Care Hospitals · Valparaiso, IN

3/5 CMS rating

OwnershipProprietary

CMS Certification Number150035

Location85 East Us Hwy 6Valparaiso, IN 46383 · Porter County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46304 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

Most-billed visit code 99213

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.

75/100

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

Scored as part of a group practice

Referred Medical Equipment & Supplies CMS DME claims

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

Walker, heavy duty, wheeled, rigid or folding, any type E0149

DME-Other DME · category DE000N

1 supplier13 claims13 services$7.72 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 20

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

ANITA K. RAO M.D.

Pain Medicine (Interventional Pain Medicine)

601 GATEWAY BLVD N
CHESTERTON, IN 46304

Porter County (219) 921-1444

BRIAN THOMAS DAMITZ D.P.M.

Podiatrist

601 GATEWAY BLVD N
CHESTERTON, IN 46304

Porter County (219) 921-1444

SAMANTHA HIGGINS DPT

Physical Therapist

601 GATEWAY BLVD N
CHESTERTON, IN 46304

Porter County (219) 921-1444

GAGE ALAN THOMA PA-C

Physician Assistant (Surgical)

601 GATEWAY BLVD N
CHESTERTON, IN 46304

Porter County (219) 921-1444

APRIL MARIE PRZYBORSKI PA-C

Physician Assistant

601 GATEWAY BLVD N
CHESTERTON, IN 46304

Porter County (219) 921-1444

ERIC KRISTIAN SZCZESNIAK M.D.

Orthopaedic Surgery

601 GATEWAY BLVD N, APT. 409
CHESTERTON, IN 46304

Porter County (219) 921-1444

THOMAS H KAY M.D.

Orthopaedic Surgery

601 GATEWAY BLVD N
CHESTERTON, IN 46304

Porter County (219) 921-1444

NATALIE JOAN EDDY NP

Nurse Practitioner

601 GATEWAY BLVD N, #A
CHESTERTON, IN 46304

Porter County (219) 921-1444

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 Paul Gruszka's NPI number?

The NPI number for Paul Gruszka is 1295733889. It was assigned to this individual provider in the NPPES registry on July 8, 2005.

Where is Paul Gruszka located?

Paul Gruszka practices at 601 Gateway Blvd N, Chesterton, IN 46304. The listed phone number is (219) 921-1444.

What is Paul Gruszka's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Paul Gruszka enrolled in Medicare?

Yes. Paul Gruszka 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.

What insurance does Paul Gruszka accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Paul Gruszka 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 Paul Gruszka affiliated with any hospitals?

According to CMS data, Paul Gruszka is affiliated with Northwest Health-La Porte and Northwest Health - Porter.

When was this NPI record last updated?

The NPPES record for Paul Gruszka was last updated on December 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.