TYLER ROSS GRENDA (NPI# 1023337821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023337821 |
| Entity Type | Individual |
| Full Name | TYLER ROSS GRENDA |
| Credential | M.D. |
| Practice Address |
1100 Walnut St Fl 5 Philadelphia PA 19107-4944 |
| Mailing Address |
1025 Walnut St Ste 607 Philadelphia PA 19107-5001 |
| Practice Telephone | 2159556750 |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2019-08-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | MD468465 | PA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 4301097169 | MI | Student, Health Care |
| Street Address |
1100 WALNUT ST FL 5 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-4944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790762516 | Wilbur B. Bowne | Surgery | 1100 Walnut St Fl 5, Philadelphia, PA 19107 | 2005-12-22 |
| 1831452051 | Sagar Shailesh Kadakia | Surgery | 1100 Walnut St Fl 5, Philadelphia, PA 19107-4944 | 2012-06-21 |
| 1982964375 | David Lapham | Surgery | 1100 Walnut St Fl 5, Philadelphia, PA 19107-4944 | 2012-05-21 |
| 1225340615 | Jaime M Glorioso | Surgery | 1100 Walnut St Fl 5, Philadelphia, PA 19107 | 2010-07-14 |
| 1003040353 | Geoffrey Wayne Krampitz | Surgery | 1100 Walnut St Fl 5, Philadelphia, PA 19107 | 2009-05-14 |
| 1366651416 | Adam Seth Bodzin | Transplant Surgery | 1100 Walnut St Fl 5, Philadelphia, PA 19107-4944 | 2007-05-22 |
| 1558414011 | Susanna Matsen Nazarian | Surgery | 1100 Walnut St Fl 5, Philadelphia, PA 19107-4944 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528443041 | Michael Ibrahim | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3701 Chestnut St Apt 410, Philadelphia, PA 19104-3104 | 2015-07-27 |
| 1215279112 | Jeffrey M Dunn | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 W. Washington Sq, #1207, Philadelphia, PA 19106 | 2013-03-19 |
| 1124200167 | Charles Tanos Bakhos | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3509 N. Broad St, Philadelphia, PA 19140 | 2007-12-01 |
| 1548303464 | Srikrishna Sirivella | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Erie Ave & Front Street, St.christopher's Hospital for Children, Cardiothoracic, Philadelphia, PA 19134-1095 | 2007-02-14 |
| 1114943644 | Raphael Chun-sing Lui | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 151 W School House Ln, Philadelphia, PA 19144-3348 | 2006-07-15 |
| 1174167571 | Stc Pediatrics LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-30 |
| 1437793833 | Stc Pediatrics LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 230 N Broad St, Philadelphia, PA 19102-1121 | 2019-10-30 |
| 1255975652 | Stc Pediatrics LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5501 Old York Rd, Philadelphia, PA 19141-3018 | 2019-10-30 |
| 1629538228 | Benjamin Franklin Smood | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3400 Spruce Street, 4 Maloney, Department of Surgery, Surgery Education, Philadelphia, PA 19104 | 2019-03-21 |
| 1770068041 | Chirantan Vinodbhai Mangukia | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-10-02 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.