Individual provider Active NPI

Leah R Granucci, CPNP

  • Pediatric Nurse Practitioner
  • New York, NY
National Provider Identifier
1326164690
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
381654 Issued in NY
Practice address
3959 Broadway
Chony, 5 Tower
New York, NY 10032-1559
Phone
(212) 342-8530
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 381654 NY Primary

Addresses

Primary practice location

3959 Broadway
Chony, 5 Tower
New York, NY 10032-1559

Mailing address

2 Alexander PL
Bronxville, NY 10708-2302

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
I20171023001734 NY Practitioner - Nurse Practitioner 2769622307 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
381654NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Jan 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jan 1, 2018 Accepting new patients
Montefiore Medical Center CurrentSince Feb 14, 2020 Accepting new patients
Montefiore Medical Center CurrentSince Feb 14, 2020 Accepting new patients

Locations

450 Saint Pauls Pl
Bronx, NY 10456
Phone (718) 579-7133

977 Fox St
Bronx, NY 10459
Phone (718) 617-4449

800 E Gun Hill Rd
Bronx, NY 10467
Phone (347) 326-8488

500 E Fordham Rd
Bronx, NY 10458
Phone (718) 329-1276

3000 E Tremont Ave
Bronx, NY 10461
Phone (718) 430-6375

1180 Tinton Ave
Bronx, NY 10456
Phone (718) 842-8133

925 Astor Ave
Bronx, NY 10469
Phone (718) 293-9569

111 E 210th St
Bronx, NY 10467

1619 Boston Rd
Bronx, NY 10460
Phone (718) 589-1590

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

1521 Jarret Pl
Bronx, NY 10461
Phone (718) 239-8733

161 Fort Washington Ave
Fl 2
New York, NY 10032
Phone (212) 305-4308

3959 Broadway
#5
New York, NY 10032
Phone (212) 305-5808

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

51 W 51st St
Ste 370
New York, NY 10019
Phone (631) 254-5577

579 Warburton Ave
Yonkers, NY 10701

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: lgranucci@montefioredirect.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326164690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ALEXANDER PL",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107082302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "address_2": "CHONY, 5 TOWER",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-342-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANUCCI",
        "first_name": "LEAH",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "381654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.