Individual provider Active NPI

Jennifer Grunhut

  • Physician Assistant
  • New Square, NY
National Provider Identifier
1083264253
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
728 N Main St
New Square, NY 10977-8916
Phone
(845) 354-9300
NPI assigned
Sep 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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 Primary

Addresses

Primary practice location

728 N Main St
New Square, NY 10977-8916

Mailing address

43 Newport Dr
Nanuet, NY 10954-3111
Phone (347) 564-2509

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
I20240522001027 NY Practitioner - Physician Assistant 8325480304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Refuah Health Center Inc 88 clinicians

Practice addresses (Care Compare)

36 Laurel Ave
South Fallsburg, NY 12779-5804
Phone (845) 482-9394

728 N Main St
New Square, NY 10977-8916
Phone (845) 354-9300

National Provider Directory

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

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
Refuah Health Center Inc CurrentSince May 13, 2024 Accepting new patients
Refuah Health Center, Inc. Past Accepting new patients

Locations

205 Airport Executive Park
Nanuet, NY 10954
Phone (845) 356-3610

728 N Main St
New Square, NY 10977
Phone (845) 354-9301

5 Twin Ave
Spring Valley, NY 10977
Phone 84535493001249

Networks

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

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": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1083264253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 NEWPORT DR",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109543111",
            "telephone_number": "347-564-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 N MAIN ST",
            "city": "NEW SQUARE",
            "state": "NY",
            "postal_code": "109778916",
            "telephone_number": "845-354-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNHUT",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Square, NY

Sources for this page

Verify at the official NPI Registry.