Individual provider Active NPI

Manpreet Grewal, M.D

  • Psychiatry Physician
  • Kingston, NY
National Provider Identifier
1013200161
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
276979 Issued in NY
Practice address
105 Marys Ave
Kingston, NY 12401-5848
Phone
(734) 756-5066
NPI assigned
May 24, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 276979 NY Primary

Addresses

Primary practice location

105 Marys Ave
Kingston, NY 12401-5848

Mailing address

105 Marys Ave
Kingston, NY 12401-5848
Phone (734) 756-5066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160225000040 NY Practitioner - Psychiatry 4183929409 Reassigns benefits to 3 organizations
I20210127002185 MI Practitioner - Psychiatry 4183929409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Horizon Counseling Center IncGroup PAC ID 4880681295, 87 clinicians

Practice addresses (Care Compare)

10819 Rockaway Blvd
South Ozone Park, NY 11420-1034
Phone (718) 845-2620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
276979NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family and Children'S Services, Inc CurrentSince Apr 7, 2020 Accepting new patients
Jewish Board of Family & Childrens Services Inc Current Accepting new patients
New Horizon Counseling Center Inc CurrentSince Oct 1, 2020 Accepting new patients
St Joseph Mercy Hospital Psychiatry CurrentSince Jan 1, 2021 Accepting new patients
St Joseph Mercy Hospital CurrentSince Jan 1, 2021 Accepting new patients
St Joseph Mercy Hospital Current Accepting new patients
Jewish Board of Family and Children'S Services, Inc. CurrentSince Apr 7, 2020 Accepting new patients
Family Services, Inc. Psychiatry CurrentSince Apr 18, 2020 Accepting new patients
Texas San Marcos Treatment Center, LP Psychiatry Past Accepting new patients

Locations

20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925

5361 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-1300

2488 Grand Concourse
Bronx, NY 10458
Phone (212) 695-5122

3600 Jerome Ave
Bronx, NY 10467
Phone (718) 366-8400

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

445 Oak St
Copiague, NY 11726
Phone (631) 257-5173

29 N Hamilton St
Poughkeepsie, NY 12601
Phone (845) 452-1110

239 Golden Hill Ln
Saint Remy, NY 12401
Phone 84534040004189

10819 Rockaway Blvd
South Ozone Park, NY 11420
Phone (718) 327-7202

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1013200161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MARYS AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015848",
            "telephone_number": "734-756-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MARYS AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015848",
            "telephone_number": "734-756-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "MANPREET",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "276979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.