Grace Medical Group LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

GRACE MEDICAL GROUP LLC

Practice address

1600 Saint Georges Ave Ste 118
Rahway, NJ 07065-2713

Phone

(732) 596-1088

NPI assigned

Jan 10, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Akinlabi Adetayo Sanusi, M.D.NPI 1790126803

Title

President

Phone

(732) 596-1088

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Akinlabi Adetayo Sanusi, M.D

  • Psychiatry Physician
  • Perth Amboy, NJ
  • NPI 1790126803
  Medicare reassignment Care Compare group NPD Authorized official
• Ugochi Abazie, DNP, APN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Roselle, NJ
  • NPI 1932675592
  Medicare reassignment Care Compare group NPD
• Tina Marie Butler, LPC

  • Professional Counselor
  • Bound Brook, NJ
  • NPI 1790997575
  Medicare reassignment Care Compare group NPD
• Christopher Castro, LMFT

  • Mental Health Counselor
  • Rahway, NJ
  • NPI 1114525045
  Medicare reassignment Care Compare group NPD
• Anastasia A. Krosnick, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Hackensack, NJ
  • NPI 1629552245
  Medicare reassignment NPD
• Martine J Jones

  • Psychiatry Physician
  • New York, NY
  • NPI 1265082812

  NJ

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515542400000",
    "number": "1003323155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SAINT GEORGES AVE STE 118",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070652713",
            "telephone_number": "732-596-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SAINT GEORGES AVE STE 118",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070652713",
            "telephone_number": "732-596-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-01-10",
        "status": "A",
        "authorized_official_last_name": "SANUSI",
        "authorized_official_first_name": "AKINLABI",
        "authorized_official_middle_name": "ADETAYO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-596-1088",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raquel Carina Goncalves, APN
• Good Neighbor Support Services
• Good Neighbor Support Services LLC
• Rita U Goradia, MD
• Keith M Gottesdiener, M.D.
• Amanda Alhout Gredzik, O.D.
• Jacob Andrew Gredzik, OD
• Jordan Michael Greenberg, PA-C
• Lauren Greenspan, RDN
• Alexandra Guy, LCSW

• Psychiatry Physician in Rahway, NJ
• Providers in Rahway, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.