Pinegrove Manor II, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2913301N Issued in NY

Legal business name

PINEGROVE MANOR II, LLC

Doing business as

Grace Plaza Nursing and Rehabilitation Center

Practice address

15 Saint Pauls PL
Great Neck, NY 11021-2636

Phone

(516) 466-3001

Fax

(516) 466-7624

NPI assigned

May 24, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly Sodano

Title

Administrator

Phone

(516) 466-3001

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Grace Plaza Nursing and Rehabilitation Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nerlige Basavaraju, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Brooklyn, NY
  • NPI 1205827680
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1255334082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SAINT PAULS PL",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212636",
            "telephone_number": "516-466-3001",
            "fax_number": "516-466-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SAINT PAULS PL",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212636",
            "telephone_number": "516-466-3001",
            "fax_number": "516-466-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEGROVE MANOR II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "SODANO",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-466-3001",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "2913301N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "335483",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "007385",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00309119",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A418337",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Plaza Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Pierre
• Jennifer D Pierre
• Stephanie Soberanis Pikul, NP
• Nirmala Pillalamarri, M.D.
• Barry S Pinchoff, MD
• Ping Zhang Acupuncture PLLC
• Valerie Lynne Pinhas, PH.D
• Natela Pinkhasova, M.S. SLP-CCC
• Elizabeth L Pinsky, LCSW
• Olivia Pinsley, PH.D,,LCSW

• Skilled Nursing Facility in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.