Individual provider Active NPI

Nicolas Krasovec Grundmann, M.D.

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1215377767
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
285543 Issued in NY
Practice address
26 Court St Ste 1901
Brooklyn, NY 11242-1119
Phone
(347) 547-3258
NPI assigned
Jun 28, 2013
Last updated
Nov 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 285543 NY Primary

Addresses

Primary practice location

26 Court St Ste 1901
Brooklyn, NY 11242-1119

Mailing address

26 Court St Ste 1901
Brooklyn, NY 11242-1119
Phone (347) 547-3258

Other practice location 1

1710 Harper Rd
Emergency Department Administrative Offices
Beckley, WV 25801-3357
Phone (304) 256-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ember Health Medical Infusions P.C. Emergency Medicine CurrentSince Jan 17, 2022 Accepting new patients
Emergency Physician Services of New York, P.C. Emergency Medicine Past Accepting new patients

Locations

26 Court St
Ste 1901
Brooklyn, NY 11242
Phone (347) 201-1547

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1215377767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 COURT ST STE 1901",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112421119",
            "telephone_number": "347-547-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 COURT ST STE 1901",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112421119",
            "telephone_number": "347-547-3258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1710 Harper Rd",
            "address_2": "Emergency Department Administrative Offices",
            "address_purpose": "LOCATION",
            "city": "Beckley",
            "state": "WV",
            "postal_code": "258013357",
            "country_code": "US",
            "telephone_number": "304-256-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUNDMANN",
        "first_name": "NICOLAS",
        "middle_name": "KRASOVEC",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-28",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "285543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.