Individual provider Active NPI

Paul John Grubner Jr., PA

  • Surgical Physician Assistant
  • Utica, NY
National Provider Identifier
1093223760
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
1656 Champlin Ave
Utica, NY 13502-4830
Phone
(315) 624-6000
NPI assigned
Jan 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

1656 Champlin Ave
Utica, NY 13502-4830

Mailing address

2209 Genesee Street
Business Office Room 310
Utica, NY 13501-5930
Phone (315) 801-3282

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
I20180302000282 NY Practitioner - Physician Assistant 3173884301 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 624-6000

1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 625-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021780NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Feb 2, 2023 Accepting new patients
New York Medical Physician Associates PC CurrentSince Jun 17, 2024 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Nov 5, 2024 Accepting new patients
New York Medical Physician Associates PC CurrentSince Jun 17, 2024 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Nov 5, 2024 Accepting new patients
MVHS Inc CurrentSince Feb 2, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534

1656 Champlin Ave
Utica, NY 13502
Phone (315) 624-6241

2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282

Interoperability endpoints

  • Direct secure messaging: pgrubner11490@mvhealthsystem.direct-ci.com

Organizations & group practices 6

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 1

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": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1093223760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 GENESEE STREET",
            "address_2": "BUSINESS OFFICE ROOM 310",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015930",
            "telephone_number": "315-801-3282",
            "fax_number": "315-801-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 CHAMPLIN AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135024830",
            "telephone_number": "315-624-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBNER",
        "first_name": "PAUL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.