Angie Gruban

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3075 47TH St
Astoria, NY 11103-1530

Phone

(347) 686-4063

NPI assigned

Aug 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• New York Psychotherapy and Counseling Center

  • Community/Behavioral Health Agency
  • Jamaica, NY
  • NPI 1902811342
  Medicare reassignment NPD
• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1053031195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 47TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111031530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 47TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111031530",
            "telephone_number": "347-686-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBAN",
        "first_name": "ANGIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Grigoratos, DDS
• Zachary William Grill
• Veronica Grivas, PHARMD
• Richard Alexander Groll, PMHNP
• Grow and Blossom Speech and Language Services, PLLC
• Elizabeth Grumley, COTA/L
• Breanna C Grusnick
• GSR Pharmacy Inc
• Guardian Apothecary Inc
• Urbano Guarin, MD

• Mental Health Counselor in Astoria, NY
• Providers in Astoria, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.