NPIMap

Individual provider Active NPI

Ilana S. Grunwald, PH.D.

  • Clinical Neuropsychologist
  • New York, NY
National Provider Identifier
1073726816
Registry record updated Nov 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
012877-1 Issued in NY
Practice address
240 E 38TH St
17TH Floor
New York, NY 10016-2708
Phone
(212) 263-5999
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 012877-1 NY Primary
Psychologist 103T00000X 012877-1 NY

Addresses

Primary practice location

240 E 38TH St
17TH Floor
New York, NY 10016-2708

Mailing address

240 E 38TH St
17TH Floor
New York, NY 10016-2708
Phone (212) 263-5999

Other identifiers 1

IdentifierTypeStateIssuer
02634802MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040406001817 NY Practitioner - Clinical Psychologist 0446243299 Reassigns benefits to 1 organization
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
State University of New York Downstate Medical Center, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

600 3Rd Ave
Suite 265
New York, NY 10016-1901
Phone (917) 488-9573

Hospital & facility affiliations

  • Rusk Rehabilitation Inpatient rehabilitation facility, New York, NY, CCN 33T214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012877-1NYMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Iospa Psychiatry Consulting, P.C. CurrentSince Jan 1, 2016 Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448841600000",
    "number": "1073726816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 E 38TH ST",
            "address_2": "17TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100162708",
            "telephone_number": "212-263-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E 38TH ST",
            "address_2": "17TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100162708",
            "telephone_number": "212-263-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNWALD",
        "first_name": "ILANA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2015-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "012877-1",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "012877-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02634802",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.