Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shelly Stephens Groenendyk, MD

Individual provider Anesthesiology Physician · NPI 1083060917

Shelly Stephens Groenendyk, MD is an Anesthesiology in Port Jefferson, New York. Graduated from University of Tennessee, Hsc, College of Medicine in 2016, 10 years ago. Practices with North Shore - Lij Anesthesiology, PC, a 1,004-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in New York, Tennessee and Utah.

Years since qualifying
10
Trained at
University of Tennessee, Hsc, College of Medicine
Licensed in
NY, TN, UT
In the registry since
2016
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

75 N Country Rd
Port Jefferson, NY 11777-2190
Phone: (516) 382-7399
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3601 The Vanderbilt Clinic, Nashville, TN 37232-0001 — (615) 322-3000
  • 3601 The Vanderbilt Clinic, Nashville, TN 37232-0001 — (615) 322-3000

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 329018 (NY)
Anesthesiology Physician Taxonomy 207L00000X · Licence 10516430-1205 (UT)
Anesthesiology Physician Taxonomy 207L00000X · Licence 63603 (TN)

Record details

NPI number1083060917
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 10, 2016
Last updated in NPPESNovember 3, 2024
Certification dateNovember 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolUNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice North Shore - Lij Anesthesiology, Pc — 1004 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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