Active NPI
Matthew Jake Grundstein
- Orthopedic Physical Therapist
- New York, NY
National Provider Identifier
1043788318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 035980
- Practice address
- 525 E 71St St
New York, NY 10021-4828 - Phone
- (212) 606-1005
- NPI assigned
- Nov 5, 2018
- Last updated
- Nov 5, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 035980 | NY | Primary |
Addresses
Primary practice location
525 E 71St St
New York, NY 10021-4828
Mailing address
535 E 70TH St
New York, NY 10021-4898
Phone (212) 606-1225
Other practice location 1
180 Central Park S
New York, NY 10019-1562
Phone (212) 767-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 035980 | NY | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541376000000",
"number": "1043788318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 E 70TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214898",
"telephone_number": "212-606-1225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 E 71ST ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214828",
"telephone_number": "212-606-1005"
}
],
"practiceLocations": [
{
"address_1": "180 Central Park S",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100191562",
"country_code": "US",
"telephone_number": "212-767-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRUNDSTEIN",
"first_name": "MATTHEW",
"middle_name": "JAKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-05",
"last_updated": "2018-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NY",
"license": "035980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.