Active NPI 1124037650 Individual Practitioner Male Practitioner

Dr. Robert Jeff Grondel , MD

Orthopaedic Surgery • Blackfoot, ID

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Robert Grondel, MD is a certified Orthopaedic Surgery practicing in Blackfoot, ID. With approximately 38 years of clinical experience since graduating from University Of Utah School Of Medicine in 1988, Dr. Grondel delivers high-quality medical care to the local community at 98 POPLAR ST.

Dr. Grondel maintains professional affiliations with Bmh Inc, Bingham Memorial Hospital and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, aspiration and/or injection of fluid from large joint, x-ray of knee. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

98 Poplar St

Blackfoot, ID 832211758

Telephone 2082737700

Fax 7025658898

Associated Practice Facility / Clinic

🏢 Bmh Inc Facility NPI 1730174830

Medicare Profile & Education

Medical School

University Of Utah School Of Medicine

Graduation Year

1988

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Blackfoot, ID

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

38 Yrs -5.5 yrs vs City Avg

City Avg: 43.5 Yrs

State Avg: 25.4 Yrs

Regional Practice Density

2 Specialists

Practicing in Blackfoot, ID (168 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

68.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Grondel (38 Years) 38 Yrs

Blackfoot Specialty Average (43.5 Years) 43.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	493	267	$374.71	$126.44
20610 Aspiration and/or injection of fluid from large joint	221	156	$192.23	$64.26
73564 X-ray of knee, 4 or more views	192	135	$138.88	$45.79
J1885 Injection, ketorolac tromethamine, per 15 mg	162	66	$3.76	$0.54
73030 X-ray of shoulder, minimum of 2 views	157	91	$100.98	$34.33
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	115	75	$21.10	$6.59
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	111	111	$460.18	$158.85
73562 X-ray of knee, 3 views	69	47	$120.53	$39.44
73502 X-ray of hip, 2-3 views	67	44	$136.31	$44.97
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	54	36	$1034.79	$510.13
73110 X-ray of wrist, minimum of 3 views	51	21	$112.78	$40.67
27447 Replacement of knee joint, both sides of knee	23	22	$3841.83	$1304.18
73080 X-ray of elbow, minimum of 3 views	21	13	$97.38	$33.08
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$313.63	$111.31
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	20	19	$518.92	$174.85
73610 X-ray of ankle, minimum of 3 views	19	14	$108.48	$33.82
20985 Computer-assisted surgery for muscle and bone procedure	17	16	$431.43	$146.46
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	11	11	$523.83	$170.62
29823 Removal of extensive shoulder joint tissue using an endoscope	11	11	$1727.72	$123.73
29827 Repair of shoulder rotator cuff using an endoscope	11	11	$3042.95	$1051.90

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	612	306	$235.00	$128.72
20610 Aspiration and/or injection of fluid from large joint	276	181	$160.62	$64.74
J1885 Injection, ketorolac tromethamine, per 15 mg	258	86	$10.00	$0.55
73564 X-ray of knee, 4 or more views	246	152	$131.00	$47.48
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	212	118	$10.00	$6.68
73030 X-ray of shoulder, minimum of 2 views	201	122	$93.00	$35.42
73502 X-ray of hip, 2-3 views	141	92	$85.00	$47.77
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	107	107	$229.63	$113.21
99213 Established patient office or other outpatient visit, typically 15 minutes	102	89	$160.00	$93.06
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	100	100	$354.60	$171.96
73110 X-ray of wrist, minimum of 3 views	93	39	$112.00	$41.66
73562 X-ray of knee, 3 views	84	51	$112.00	$41.58
73610 X-ray of ankle, minimum of 3 views	64	28	$100.00	$37.64
73080 X-ray of elbow, minimum of 3 views	57	33	$102.00	$33.47
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	48	34	$1500.00	$1031.53
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance	32	28	$294.69	$120.06
27447 Replacement of knee joint, both sides of knee	28	26	$6314.29	$1351.10
72080 X-ray of middle and lower spine, 2 views	15	15	$110.00	$35.90
73522 X-ray of both hips, 3-4 views	14	11	$125.00	$55.47
27130 Replacement of thigh bone and hip joint with prosthesis	13	13	$6400.00	$1304.58
23472 Prosthetic repair of shoulder joint, total shoulder	11	11	$6600.00	$1523.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1885 Injection, ketorolac tromethamine, per 15 mg	451	82	$10.00	$0.50
99213 Established patient office or other outpatient visit, typically 15 minutes	313	204	$160.00	$93.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	274	204	$235.00	$133.43
20610 Aspiration and/or injection of fluid from large joint	239	168	$179.64	$70.53
73564 X-ray of knee, 4 or more views	227	146	$131.00	$47.11
73030 X-ray of shoulder, minimum of 2 views	214	115	$93.00	$35.08
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	192	81	$10.00	$6.97
73502 X-ray of hip, 2-3 views	125	87	$85.00	$47.47
73562 X-ray of knee, 3 views	106	62	$112.00	$41.51
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	102	102	$230.00	$114.23
73110 X-ray of wrist, minimum of 3 views	80	35	$112.00	$41.51
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	59	37	$1500.00	$1219.00
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	58	58	$355.00	$173.42
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	44	39	$95.00	$57.69
97140 Therapy procedure using manual technique, each 15 minutes	38	16	$72.58	$13.19
97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	35	17	$78.90	$18.27
73080 X-ray of elbow, minimum of 3 views	34	22	$102.00	$33.12
73610 X-ray of ankle, minimum of 3 views	32	16	$100.00	$37.66
97530 Therapy procedure using functional activities	30	13	$101.45	$23.89
27447 Replacement of knee joint, both sides of knee	24	24	$6800.00	$1373.62
73522 X-ray of both hips, 3-4 views	22	21	$125.00	$54.81
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance	18	18	$288.33	$117.72
72100 X-ray of lower and sacral spine, 2-3 views	17	17	$111.00	$40.82
29823 Removal of extensive shoulder joint tissue using an endoscope	11	11	$2800.00	$130.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7318 Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg	3,901	42	$25.00	$18.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	405	253	$235.00	$111.10
J1885 Injection, ketorolac tromethamine, per 15 mg	401	86	$10.00	$0.56
20610 Aspiration and/or injection of fluid from large joint	281	198	$174.86	$67.93
73030 X-ray of shoulder, minimum of 2 views	219	115	$93.00	$33.66
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	211	110	$10.00	$7.02
73564 X-ray of knee, 4 or more views	186	130	$131.00	$44.79
73502 X-ray of hip, 2-3 views	183	106	$85.00	$46.24
99213 Established patient office or other outpatient visit, typically 15 minutes	158	125	$160.00	$76.54
73562 X-ray of knee, 3 views	126	68	$112.00	$39.64
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	103	103	$230.00	$110.89
73110 X-ray of wrist, minimum of 3 views	57	15	$112.00	$39.68
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	54	54	$355.00	$169.70
72100 X-ray of lower and sacral spine, 2-3 views	36	35	$111.00	$39.00
73610 X-ray of ankle, minimum of 3 views	33	17	$100.00	$33.79
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	30	28	$435.00	$208.62
27447 Replacement of knee joint, both sides of knee	27	26	$6800.00	$1445.23
73080 X-ray of elbow, minimum of 3 views	24	21	$102.00	$31.66
27130 Replacement of thigh bone and hip joint with prosthesis	18	18	$6400.00	$1445.42
73522 X-ray of both hips, 3-4 views	16	16	$125.00	$53.09
73502 X-ray of hip, 2-3 views	14	13	$85.00	$11.64
A4565 Slings	14	14	$20.00	$8.87
29823 Removal of extensive shoulder joint tissue using an endoscope	11	11	$2800.00	$167.01
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	11	11	$2300.00	$185.75
23472 Prosthetic repair of shoulder joint, total shoulder	11	11	$6600.00	$1550.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7318 Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg	1,741	23	$25.00	$16.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	748	375	$234.59	$108.43
J1885 Injection, ketorolac tromethamine, per 15 mg	411	91	$10.00	$0.51
20610 Aspiration and/or injection of fluid from large joint	345	227	$175.22	$63.91
73562 X-ray of knee, 3 views	298	157	$112.00	$37.76
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	278	141	$10.00	$6.66
73030 X-ray of shoulder, minimum of 2 views	253	128	$93.00	$30.31
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	208	208	$230.00	$107.93
73502 X-ray of hip, 2-3 views	183	123	$85.00	$43.30
73564 X-ray of knee, 4 or more views	92	65	$131.00	$41.28
99213 Established patient office or other outpatient visit, typically 15 minutes	90	82	$160.00	$75.22
73110 X-ray of wrist, minimum of 3 views	65	27	$112.00	$36.38
73610 X-ray of ankle, minimum of 3 views	51	21	$100.00	$33.32
73080 X-ray of elbow, minimum of 3 views	39	27	$102.00	$30.36
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	36	36	$435.00	$203.85
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	33	26	$650.00	$418.20
J7327 Hyaluronan or derivative, monovisc, for intra-articular injection, per dose	32	23	$1500.00	$1402.80
27447 Replacement of knee joint, both sides of knee	29	28	$6800.00	$1392.22
72100 X-ray of lower and sacral spine, 2-3 views	20	20	$111.00	$35.38
73522 X-ray of both hips, 3-4 views	19	19	$125.00	$48.28
73502 X-ray of hip, 2-3 views	19	15	$85.00	$11.47
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$355.00	$166.28
27130 Replacement of thigh bone and hip joint with prosthesis	16	16	$6400.00	$1392.92
29823 Removal of extensive shoulder joint tissue using an endoscope	16	16	$2800.00	$146.34
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	15	15	$2300.00	$180.28
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	15	15	$310.00	$147.34
29824 Partial removal of collar bone at shoulder using an endoscope	14	14	$2900.00	$245.60
A4565 Slings	13	13	$20.00	$8.22
29827 Repair of shoulder rotator cuff using an endoscope	13	13	$4800.00	$1084.56
27245 Treatment of broken neck of thigh bone with bone implant	12	12	$5500.00	$1265.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	633	336	$196.59	$107.30
J1885 Injection, ketorolac tromethamine, per 15 mg	387	89	$10.00	$0.57
73562 X-ray of knee, 3 views	376	212	$112.00	$35.75
20610 Aspiration and/or injection of fluid from large joint	362	244	$169.56	$62.72
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	320	160	$10.00	$7.12
73030 X-ray of shoulder, minimum of 2 views	242	139	$93.00	$29.55
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	216	216	$191.67	$108.34
73502 X-ray of hip, 2-3 views	184	128	$85.00	$41.98
99213 Established patient office or other outpatient visit, typically 15 minutes	176	149	$126.79	$73.29
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	78	56	$650.00	$516.91
73110 X-ray of wrist, minimum of 3 views	67	34	$112.00	$35.50
73610 X-ray of ankle, minimum of 3 views	56	26	$100.00	$31.32
73080 X-ray of elbow, minimum of 3 views	50	30	$102.00	$31.44
72100 X-ray of lower and sacral spine, 2-3 views	42	41	$111.00	$35.49
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	33	33	$243.79	$137.33
73522 X-ray of both hips, 3-4 views	23	20	$125.00	$47.30
27447 Replacement of knee joint, both sides of knee	23	22	$6800.00	$1208.33
27130 Replacement of thigh bone and hip joint with prosthesis	20	19	$6400.00	$1351.63
73502 X-ray of hip, 2-3 views	20	17	$85.00	$11.37
A4565 Slings	17	17	$20.00	$8.52
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$279.71	$165.59
29823 Removal of extensive shoulder joint tissue using an endoscope	13	13	$2800.00	$143.99
29827 Repair of shoulder rotator cuff using an endoscope	12	11	$4800.00	$1076.18
29824 Partial removal of collar bone at shoulder using an endoscope	12	12	$2900.00	$210.92
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	12	$245.00	$146.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	759	393	$185.00	$108.11
73562 X-ray of knee, 3 views	378	224	$112.00	$36.17
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	354	164	$10.00	$6.77
20610 Aspiration and/or injection of fluid from large joint	309	216	$170.55	$62.96
73030 X-ray of shoulder, minimum of 2 views	234	133	$93.00	$29.49
73502 X-ray of hip, 2-3 views	174	120	$85.00	$42.44
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	169	169	$185.00	$108.76
J1885 Injection, ketorolac tromethamine, per 15 mg	128	58	$10.00	$0.61
99213 Established patient office or other outpatient visit, typically 15 minutes	117	101	$125.00	$73.57
73110 X-ray of wrist, minimum of 3 views	75	32	$112.00	$35.81
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	61	61	$275.00	$162.19
73610 X-ray of ankle, minimum of 3 views	57	31	$100.00	$32.26
73080 X-ray of elbow, minimum of 3 views	53	31	$102.00	$31.31
72100 X-ray of lower and sacral spine, 2-3 views	48	46	$111.00	$35.86
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	48	34	$643.75	$545.03
73630 X-ray of foot, minimum of 3 views	33	18	$95.00	$29.71
73522 X-ray of both hips, 3-4 views	28	26	$125.00	$46.94
73502 X-ray of hip, 2-3 views	25	19	$85.00	$11.42
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	22	22	$230.00	$137.98
73130 X-ray of hand, minimum of 3 views	21	17	$97.00	$31.56
A4565 Slings	17	17	$20.00	$8.43
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	17	17	$300.00	$204.24
29827 Repair of shoulder rotator cuff using an endoscope	17	16	$4800.00	$1084.16
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	15	15	$2300.00	$181.21
29824 Partial removal of collar bone at shoulder using an endoscope	15	15	$2900.00	$200.16
27447 Replacement of knee joint, both sides of knee	15	14	$6800.00	$1392.93
73562 X-ray of knee, 3 views	15	11	$112.00	$9.63
27130 Replacement of thigh bone and hip joint with prosthesis	14	14	$6400.00	$1322.14
29823 Removal of extensive shoulder joint tissue using an endoscope	14	14	$2800.00	$150.73

Medical Specialties & State Licenses

CMS Verified: 2025-10-28

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License ID M16347

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.

Orthopaedic Surgery - Sports Medicine

NUCC Taxonomy Code: 207XX0005X

State License ID M16347

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

002019572 (NV)

Commercial Insurance / Payer ID Railroad Medicare

200030368 (NV)

Hospital & Practice Group Affiliations

Bingham Memorial Hospital

98 Poplar St, Blackfoot, ID 832211758

Bmh Inc

98 Poplar St, Blackfoot, ID 832211758

Bmh Inc

98 Poplar St, Blackfoot, ID 832211758

Phone: 2087854100

Bmh Inc

315 W Idaho St, Blackfoot, ID 832211711

Phone: 2087823990

Secondary Practice Locations

3302 Valencia Dr

Idaho Falls, ID 834047058

Phone: 2082737700

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

27 Associated Practitioners

Dr. Jason Melton , PT, DPT

Physical Therapist

NPI 1013348754

Physical Therapist, Doctor of Physical Therapy

Dr. Celine Truong , PT, DPT

Physical Therapist

NPI 1033803648

Physical Therapist, Doctor of Physical Therapy

Dr. Robert Tait , MD

Orthopaedic Surgery

NPI 1053320564

Doctor of Medicine (M.D.)

Dr. Steven Hoer , MD

Orthopaedic Surgery

NPI 1124037734

Doctor of Medicine (M.D.)

Charlotte Izatt , PT

Physical Therapist

NPI 1174773618

Physical Therapist

Allan Jordan , CST

Specialist/Technologist, Other - Surgical Technologist

NPI 1205088895

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location October 28, 2025

Registered at 98 POPLAR ST, BLACKFOOT, ID 832211758 (Tel: 2082737700)

📍

Updated Business Mailing Address October 28, 2025

Registered at 98 POPLAR ST, BLACKFOOT, ID 832211758 (Tel: 2082737700)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 28, 2025

Orthopaedic Surgery (License #M16347 in ID)

✅

NPI Profile Active March 22, 2010

NPI status registered as active in NPPES database

📍

Updated Practice Location March 22, 2010

Registered at 10561 JEFFREYS ST, SUITE 230, HENDERSON, NV 890524266 (Tel: 7025656565)

📍

Updated Business Mailing Address March 22, 2010

Registered at 10561 JEFFREYS ST, SUITE 230, HENDERSON, NV 890524266 (Tel: 7025656565)

👤

Provider Name / Credentials Updated March 22, 2010

Recorded as ROBERT GRONDEL, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 22, 2010

Orthopaedic Surgery (License #7523 in NV)

🟢

Initial NPI Registration & Enumeration August 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1124037650

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 05, 2006

Last Update: October 28, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

98 Poplar St

Blackfoot, ID 832211758

Phone: 2082737700

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.