Active NPI
Kathleen M Grady, ANP
- Adult Health Nurse Practitioner
- New Hyde Park, NY
National Provider Identifier
1073739074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F303134
- Practice address
- 3003 New Hyde Park Road
Suite 411
New Hyde Park, NY 11042 - Phone
- (516) 327-0001
- Fax
- (516) 326-9753
- NPI assigned
- Apr 18, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F303134 | NY | Primary |
Addresses
Primary practice location
3003 New Hyde Park Road
Suite 411
New Hyde Park, NY 11042
Mailing address
3003 New Hyde Park Road
Suite 411
New Hyde Park, NY 11042
Phone (516) 327-0001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170227000836 | NY | Order and Referring Only - Nurse Practitioner | 9931340940 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F303134 | NY | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiovascular Consultants of Li | Past | Accepting new patients | |
| CHS Physician Partners, P.C | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- kathleen.gradyanp.p1@direct.ccli.nextgenshare.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Cardiovascular Disease Physician
- New Hyde Park, NY
- NPI 1003988254
-
- Cardiovascular Disease Physician
- Roslyn, NY
- NPI 1164585725
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073739074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3003 NEW HYDE PARK ROAD",
"address_2": "SUITE 411",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "11042",
"telephone_number": "516-327-0001",
"fax_number": "516-326-9753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3003 NEW HYDE PARK ROAD",
"address_2": "SUITE 411",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "11042",
"telephone_number": "516-327-0001",
"fax_number": "516-326-9753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADY",
"first_name": "KATHLEEN",
"middle_name": "M",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F303134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.