Individual provider Active NPI

Mark T Grusso, DPM

  • Podiatrist
  • Phillipsburg, NJ
National Provider Identifier
1144260175
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MD01998 Issued in NJ
Practice address
409 Coventry Dr
Phillipsburg, NJ 08865-1969
Phone
(908) 213-0029
Fax
(908) 213-9393
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X MD01998 NJ Primary

Addresses

Primary practice location

409 Coventry Dr
Phillipsburg, NJ 08865-1969

Mailing address

409 Coventry Dr
Phillipsburg, NJ 08865-1969
Phone (908) 213-0029

Other identifiers 2

IdentifierTypeStateIssuer
0037702MedicaidNJ
P00074810OtherNJRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040224000047 NJ Practitioner - Podiatry 3577458173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

409 Coventry Dr
Phillipsburg, NJ 08865-1969
Phone (484) 822-6221

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue129
Removal of skin lesions37
Removal of nail tissue559
Removal or shaving of skin growth393
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD01998NJMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Warren Physician Group, PC Current Accepting new patients
St. Luke'S Warren Physician Group, PC CurrentSince Oct 1, 2023 Accepting new patients
St. Luke'S Warren Physician Group, PC CurrentSince Oct 1, 2023 Accepting new patients
St. Luke'S Physician Group, Inc. Past Accepting new patients

Locations

187 County Road 519
Ste 2
Belvidere, NJ 07823
Phone (908) 213-0029

755 Memorial Pkwy
Ste 201
Phillipsburg, NJ 08865
Phone (484) 503-0055

200 Strykers Rd
Phillipsburg, NJ 08865
Phone (908) 847-1035

185 Roseberry St
Bldg 2ND
Phillipsburg, NJ 08865
Phone (908) 847-2619

228 Roseberry St
Ste 5
Phillipsburg, NJ 08865
Phone (908) 213-3433

409 Coventry Dr
Ste 409
Phillipsburg, NJ 08865

409 Coventry Dr
Phillipsburg, NJ 08865
Phone (908) 213-0029

315 State Route 31 S
Washington, NJ 07882
Phone (908) 689-0777

Interoperability endpoints

  • Direct secure messaging: mark.grusso@slpg.direct-sluhn.org

Organizations & group practices 4

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 7

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1144260175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 COVENTRY DR",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651969",
            "telephone_number": "908-213-0029",
            "fax_number": "908-213-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 COVENTRY DR",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651969",
            "telephone_number": "908-213-0029",
            "fax_number": "908-213-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSSO",
        "first_name": "MARK",
        "middle_name": "T",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD01998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0037702",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00074810",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

Verify at the official NPI Registry.