Individual provider Active NPI

Marienellie Grandchamps, FNP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1295451029
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F348575 Issued in NY
Practice address
2626 Halperin Ave
Bronx, NY 10461-2631
Phone
(718) 618-0401
NPI assigned
Oct 13, 2022
Last updated
Oct 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F348575 NY Primary

Addresses

Primary practice location

2626 Halperin Ave
Bronx, NY 10461-2631

Mailing address

13033 228TH St
Laurelton, NY 11413-1742
Phone (347) 636-7338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221201001285 NY Practitioner - Nurse Practitioner 9335517952 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Expert Medical Services LLCGroup PAC ID 4284651738, 41 clinicians

Practice addresses (Care Compare)

33 Manors Dr
Jericho, NY 11753-1729
Phone 7182767935800

35 N Tyson Ave
Suite 100
Floral Park, NY 11001-1403
Phone (718) 276-7935

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Expert Medical Services LLC CurrentSince Dec 1, 2024 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Oct 1, 2022 Accepting new patients
Essen Medical Associates, PC CurrentSince Oct 1, 2022 Accepting new patients
Essen Medical Associates, PC CurrentSince Oct 1, 2022 Accepting new patients
Essen Medical Urgicare, PLLC CurrentSince Oct 1, 2022 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Oct 1, 2022 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Feb 3, 2025 Accepting new patients
Expert Mobile Health PastSince Mar 19, 2023 Accepting new patients

Locations

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

35 N Tyson Ave
Ste 100
Floral Park, NY 11001
Phone (718) 276-7935

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 8

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 1

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": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1295451029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13033 228TH ST",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114131742",
            "telephone_number": "347-636-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 HALPERIN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612631",
            "telephone_number": "718-618-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDCHAMPS",
        "first_name": "MARIENELLIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F348575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.