Michelle L Grant

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00908800 Issued in NJ

Practice address

110 Main Ave
Passaic, NJ 07055-4427

Phone

(973) 777-7638

Fax

(973) 777-9311

NPI assigned

Mar 8, 2019

Last updated

Jan 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jewish Family Service and Childrens Center of Clifton-Passaic, IncGroup PAC ID 3678749223, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Jewish Family Service & Childrens Center of Clifton-Passaic, Inc

  dba Jewish Family Service

  • Clinical Social Worker
  • Passaic, NJ
  • NPI 1073885026
  Medicare reassignment Care Compare group NPD
• HMH Carrier Behavioral Health Inc

  dba Hackensack Meridian Health Carrier Clinic

  • Psychiatric Hospital
  • Belle Mead, NJ
  • NPI 1225039399
  Medicare reassignment NPD

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1306304282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MAIN AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554427",
            "telephone_number": "973-777-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAIN AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554427",
            "telephone_number": "973-777-7638",
            "fax_number": "973-777-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-08",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00908800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle A Gonzalez
• Goodman Pharmacy & Surgical Inc
• Kara Lee Gordon Palley, CPT, RYT-200, PCES
• Mona Gothi, PA
• Glendolin Grant, MT
• Lucille Monica Green, APN MSN
• Kenneth M Gross, DC
• Alyssa Grossman, RD
• Jodi Hope Grossman, OTR
• Chanita Groysman

• Psychiatric/Mental Health Nurse Practitioner in Passaic, NJ
• Providers in Passaic, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.