EDWIN T MCGROARTY M.D.
NPI 1891767299
Family Medicine in Avalon, CA

Q: What is Edwin Mcgroarty's NPI number?

The NPI number for Edwin Mcgroarty is 1891767299. It was assigned to this individual provider in the NPPES registry on February 2, 2006.

Q: What is Edwin Mcgroarty's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Edwin Mcgroarty was last updated on February 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since February 02, 2006PECOS Enrolled

100 FALLS CANYON ROAD, AVALON, CA 90704(310) 510-0096(310) 510-2938 Get Directions Write a Review

NPPES record last updated: February 28, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 28, 2023, Feb 23, 2017, Mar 28, 2016 (3 updates tracked since 2016).

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About Edwin T Mcgroarty M.d. NPPES

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

EDWIN T MCGROARTY M.D. (NPI 1891767299) is an individual family medicine provider in Avalon, California, licensed in California (145912) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Mckenzie County Healthcare Systems Inc, and is a graduate of University Of Cincinnati College Of Medicine (1997).

NPPES Registry Identity

NPI1891767299

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameEDWIN T MCGROARTYCredential: M.D.

Location Address100 FALLS CANYON ROADAvalon, CA 90704-1563

Mailing AddressP.o. Box 1563Avalon, CA 90704-1563 · (310) 510-0096 · Fax (310) 510-2938

Phone(310) 510-0096

Fax(310) 510-2938

Sole ProprietorNo

Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 1997

Enumeration DateFebruary 2, 2006

Last NPPES UpdateFebruary 28, 20233 updates tracked since enumeration

NPPES CertifiedFebruary 28, 2023

✔ NPI 1891767299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · 145912

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

100 FALLS CANYON ROAD, Avalon, CA 90704

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Other Identifiers 1

OtherNM302555NM · Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edwin T Mcgroarty M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2860442514

PECOS Enrollment IDI20180302002202, I20240702004527

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 Reassignments

Medicare enrollment records show Edwin Mcgroarty reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Avalon Medical Development Corporation

Same address

Critical Access

100 FALLS CANYON ROAD
Avalon, CA 90704

Reassigned Medicare billing, California enrollment
42 clinicians in this Medicare group

NPI 1346250347 (310) 510-0700

Seneca Healthcare District

507 mi

Medicare Defined Swing Bed Unit

130 BRENTWOOD DRIVE
Chester, CA 96020

Reassigned Medicare billing, California enrollment
38 clinicians in this Medicare group

NPI 1326234022 (530) 258-2151

Mckenzie County Healthcare Systems Inc

1,265 mi

Family Medicine

3 4TH ST E
Williston, ND 58801

Reassigned Medicare billing, North Dakota enrollment
Also billed through NPI 1518988948 (North Dakota)
108 clinicians in this Medicare group

NPI 1295568376 (701) 577-6337

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 5

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.

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

128 services101 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

112 services89 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

64 services49 patients

Emergency department visit with straightforward medical decision making 99282

An emergency department visit for a mild to moderate issue is when you seek immediate medical attention for a non-life-threatening condition. This could include minor injuries, moderate pain, or illnesses like the flu. During the visit, healthcare professionals assess your condition, provide treatment, and may recommend follow-up care.

49 services44 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

16 services14 patients

Hospital Affiliations CMS Care Compare

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

Mckenzie County Healthcare Systems Inc

Critical Access Hospitals · Watford City, ND

OwnershipVoluntary non-profit - Private

CMS Certification Number351302

Location709 4th Ave NEWatford City, ND 58854 · Mckenzie County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90704 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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.

Reported Quality Measures

Breast Cancer Screening

25%131 patients2/55-star benchmark: 93%

Colorectal Cancer Screening

5%343 patients1/55-star benchmark: 88%

Controlling High Blood Pressure

42%146 patients2/55-star benchmark: 91%

Diabetes: Eye Exam

2%90 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

37%90 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

79%1,907 patients3/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

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

2 suppliers12 claims24 services$2.74 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

1 supplier13 claims13 services$118.78 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier13 claims13 services$38.03 avg. paid by Medicare

Lightweight wheelchair K0003

DME-Wheelchairs · category DD000N

1 supplier16 claims16 services$35.21 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 7

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

DR. AIMEE JOANNE WARREN D.O.

Family Medicine