Individual provider Active NPI

Renje Grimes, MPH, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1073943965
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017219 Issued in NY
Practice address
222 Lenox Rd
Apt 2Z
Brooklyn, NY 11226-2179
Phone
(315) 395-9549
NPI assigned
Nov 14, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017219 NY Primary

Addresses

Primary practice location

222 Lenox Rd
Apt 2Z
Brooklyn, NY 11226-2179

Mailing address

222 Lenox Rd
Apt 2Z
Brooklyn, NY 11226-2179

Other practice location 1

150 55th St
Brooklyn, NY 11220-2508
Phone (718) 630-6745

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rgrimes133172@nyumc.direct-ci.com

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140806001282 NY Practitioner - Physician Assistant 3779700240 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York Downstate Medical Center, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brookdale Hospital Medical Center CurrentSince Feb 24, 2015 Accepting new patients
New York University CurrentSince Dec 19, 2016 Accepting new patients
Montefiore Medical Center CurrentSince May 15, 2014 Accepting new patients
Nes Medical Services of New York PC CurrentSince Apr 18, 2016 Accepting new patients
New York University CurrentSince Dec 19, 2016 Accepting new patients
Nes Medical Services of New York PC CurrentSince Apr 18, 2016 Accepting new patients
Montefiore Medical Center CurrentSince May 15, 2014 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

600 E 233rd St
Bronx, NY 10466
Phone (718) 920-1640

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

455 E Bay Dr
Long Beach, NY 11561
Phone (516) 432-8000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: regrimes@montefioredirect.com
  • Direct secure messaging: rgrimes133172@nyumc.direct-ci.com

Organizations & group practices 7

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": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1073943965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 LENOX RD",
            "address_2": "APT 2Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 LENOX RD",
            "address_2": "APT 2Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262179",
            "telephone_number": "315-395-9549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 55th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202508",
            "country_code": "US",
            "telephone_number": "718-630-6745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "RENJE",
        "credential": "MPH, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-14",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgrimes133172@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.