Active NPI
Windy Gussie Jose Grant, MD
- Pediatric Adolescent Medicine Physician
- Philadelphia, PA
National Provider Identifier
1245895937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- MD478834
- Practice address
- 3401 Civic Center Blvd
Division of Adolescent Medicine
Philadelphia, PA 19104 - Phone
- (215) 590-7430
- NPI assigned
- May 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | MT224851 | PA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Adolescent Medicine Physician | 2080A0000X | MD478834 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Division of Adolescent Medicine
Philadelphia, PA 19104
Mailing address
3401 Civic Center Blvd
Division of Adolescent Medicine
Philadelphia, PA 19104
Phone (215) 590-7430
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD478834 | PA | MD | Pediatric Adolescent Medicine Physician |
| MT224851 | PA | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Health Care Associates of New Jersey PC | Past | Accepting new patients | |
| Children's Hospital of Philadelphia | Past | Accepting new patients |
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.
-
dba CHOP Primary Care Doylestown
- Pediatrics Physician
- Doylestown, PA
- NPI 1427148808
-
dba Chca NJ
- Pediatrics Physician
- Voorhees, NJ
- NPI 1427152917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744329600000",
"number": "1245895937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF ADOLESCENT MEDICINE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "215-590-7430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF ADOLESCENT MEDICINE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "215-590-7430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "WINDY",
"middle_name": "GUSSIE JOSE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-08",
"last_updated": "2025-04-11",
"certification_date": "2025-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "PA",
"license": "MT224851",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "PA",
"license": "MD478834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.