NPIMap

Individual provider Active NPI

Jordon Guy Grube, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Albany, NY
National Provider Identifier
1114346566
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
306555 Issued in NY
Practice address
50 New Scotland Ave # MC-41
Albany, NY 12208-3403
Phone
(518) 262-5575
NPI assigned
Apr 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 306555 NY Primary

Addresses

Primary practice location

50 New Scotland Ave # MC-41
Albany, NY 12208-3403

Mailing address

30 Starbuck Dr Unit 208
Green Island, NY 12183-1264
Phone (484) 223-9635

Other practice location 1

94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone (973) 322-5000

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
I20210128001002 NY Practitioner - Otolaryngology 8426462755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Philadelphia College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Jan 4, 2021 Accepting new patients
Albany Medical College CurrentSince Jan 4, 2021 Accepting new patients
Albany Medical College CurrentSince Jan 4, 2021 Accepting new patients
Albany Medical College Current Accepting new patients

Locations

47 New Scotland Ave
#61
Albany, NY 12208
Phone (518) 262-5791

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

50 New Scotland Ave
#41
Albany, NY 12208
Phone (518) 262-5575

Interoperability endpoints

  • Direct secure messaging: jgrube25050@albanymed.direct-ci.com

Organizations & group practices 5

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 5

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": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1114346566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 STARBUCK DR UNIT 208",
            "city": "GREEN ISLAND",
            "state": "NY",
            "postal_code": "121831264",
            "telephone_number": "484-223-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 NEW SCOTLAND AVE # MC-41",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083403",
            "telephone_number": "518-262-5575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 Old Short Hills Rd",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070395672",
            "country_code": "US",
            "telephone_number": "973-322-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUBE",
        "first_name": "JORDON",
        "middle_name": "GUY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-14",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NY",
            "license": "306555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.