Individual provider Active NPI

Bridget Grant, M.D.

  • Dermatology Physician
  • Cooperstown, NY
National Provider Identifier
1336375161
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
60 275670 Issued in NY
Practice address
One Atwell Rd
Cooperstown, NY 13326-0725
Phone
(607) 547-6542
Fax
(607) 547-7662
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 60 275670 NY Primary

Addresses

Primary practice location

One Atwell Rd
Cooperstown, NY 13326-0725

Mailing address

One Atwell Rd
Cooperstown, NY 13326-0725
Phone (607) 547-6542

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141231000923 NY Practitioner - Dermatology 8123341997 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Specialists of the Capital Region, PLLCGroup PAC ID 5597741371, 12 clinicians

Practice addresses (Care Compare)

264 Washington Ave Ext
Suite 201
Albany, NY 12203-6352
Phone (518) 452-1928

Merit-based Incentive Payment System (MIPS)

Final score
92.03 of 100Reported as group
Quality
97.72
Improvement activities
40
Cost
76.47

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1058
Removal or shaving of skin growth12
Skin biopsy523

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60 275670NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Specialists of the Capital Region, PLLC CurrentSince Jun 30, 2021 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Oct 27, 2014 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Oct 27, 2014 Accepting new patients

Locations

264 Washington Avenue Ext
Ste 201
Albany, NY 12203
Phone (518) 452-1928

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

130 North St
Walton, NY 13856
Phone (607) 865-6541

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1336375161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133260725",
            "telephone_number": "607-547-6542",
            "fax_number": "607-547-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133260725",
            "telephone_number": "607-547-6542",
            "fax_number": "607-547-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "BRIDGET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "60 275670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.