Individual provider Active NPI

Matthew Grillo, MD

  • Pediatrics Physician
  • Levittown, NY
National Provider Identifier
1376907469
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
299892 Issued in NY
Practice address
2900 Hempstead Tpke Ste 205
Levittown, NY 11756
Phone
(516) 735-7181
NPI assigned
Apr 5, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 299892 NY Primary

Addresses

Primary practice location

2900 Hempstead Tpke Ste 205
Levittown, NY 11756

Mailing address

2900 Hempstead Tpke Ste 205
Levittown, NY 11756-1401
Phone (516) 735-7181

Other practice location 1

2201 Hempstead Tpke
Nassau Health Care Corporation
East Meadow, NY 11554-1859
Phone (516) 572-6177

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
I20220909001603 NY Practitioner - Pediatric Medicine 7012253750 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Health Care Corporation Single Specialty CurrentSince Apr 23, 2022 Accepting new patients
Nassau Health Care Corporation Single Specialty Current Accepting new patients
Nassau Health Care Corporation Single Specialty CurrentSince Apr 23, 2022 Accepting new patients

Locations

2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1376907469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 HEMPSTEAD TPKE STE 205",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561401",
            "telephone_number": "516-735-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 HEMPSTEAD TPKE STE 205",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "11756",
            "telephone_number": "516-735-7181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Hempstead Tpke",
            "address_2": "Nassau Health Care Corporation",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "115541859",
            "country_code": "US",
            "telephone_number": "516-572-6177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRILLO",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "299892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, NY

Sources for this page

Verify at the official NPI Registry.