Individual provider Active NPI

Gerald Grodstein, MD

  • Nephrology Physician
  • Englewood, NJ
National Provider Identifier
1245211440
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA03799200 Issued in NJ
Practice address
177 N Dean St
Suite 207
Englewood, NJ 07631-2533
Phone
(201) 567-0446
NPI assigned
Nov 7, 2005
Last updated
Nov 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25MA03799200 NJ Primary

Addresses

Primary practice location

177 N Dean St
Suite 207
Englewood, NJ 07631-2533

Mailing address

177 N Dean St
Suite 207
Englewood, NJ 07631-2533
Phone (201) 567-0446

Other identifiers 3

IdentifierTypeStateIssuer
BP293OtherNJOXFORD HEALTH
0K3260OtherNJHEALTH NET
412640OtherNJCIGNA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101129000813 NJ Practitioner - NephrologyPractitioner - Internal Medicine 5395808950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
State University of New York Downstate Medical Center, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

177 N Dean St
Englewood, NJ 07631-2533
Phone (201) 569-4901

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC CurrentSince Oct 17, 2022 Accepting new patients

Locations

177 N Dean St
Englewood, NJ 07631
Phone (201) 510-3777

177 N Dean St
Ste 207
Englewood, NJ 07631
Phone (201) 401-0374

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1245211440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 N DEAN ST",
            "address_2": "SUITE 207",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312533",
            "telephone_number": "201-567-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 N DEAN ST",
            "address_2": "SUITE 207",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312533",
            "telephone_number": "201-567-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODSTEIN",
        "first_name": "GERALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA03799200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH",
            "identifier": "BP293",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "0K3260",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "412640",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.