Individual provider Active NPI

Maria Grohovski, M.D

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1275635963
Registry record updated Jul 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
210629 Issued in NY
Practice address
1811 Quentin Rd
#1H
Brooklyn, NY 11229-1343
Phone
(718) 336-3500
Fax
(718) 336-2737
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 210629 NY Primary

Addresses

Primary practice location

1811 Quentin Rd
#1H
Brooklyn, NY 11229-1343

Mailing address

17 Harmon St
Long Beach, NY 11561-2707
Phone (718) 336-3500

Other identifiers 2

IdentifierTypeStateIssuer
01867394MedicaidNY
176AM1OtherNYEMPIRE BCBS

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

LicenseStateTypeSpecialty
210629NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Beach Medical PC Internal Medicine Past Accepting new patients
St John'S Medical Services PC Internal Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217030400000",
    "number": "1275635963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HARMON ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612707",
            "telephone_number": "718-336-3500",
            "fax_number": "718-336-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 QUENTIN RD",
            "address_2": "#1H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291343",
            "telephone_number": "718-336-3500",
            "fax_number": "718-336-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROHOVSKI",
        "first_name": "MARIA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2008-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "210629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01867394",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "176AM1",
            "state": "NY"
        }
    ],
    "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 Jul 26, 2008; 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.