Andrew Moyer Grunebaum, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

001760 Issued in CT

Practice address

999 Summer St
Suite 200
Stamford, CT 06905-5546

Phone

(203) 324-9712

Fax

(203) 357-9030

NPI assigned

Feb 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1386782290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SPOKE DR",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065251132",
            "telephone_number": "203-393-0817",
            "fax_number": "203-357-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 SUMMER ST",
            "address_2": "SUITE 200",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055546",
            "telephone_number": "203-324-9712",
            "fax_number": "203-357-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNEBAUM",
        "first_name": "ANDREW",
        "middle_name": "MOYER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "001760",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "001760",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN NUMBER",
            "identifier": "4309291",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS ID",
            "identifier": "060001760CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI-VALUEOPTIONS ID",
            "identifier": "6893902",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew W Grose, MD
• Charles Gross, DPM
• Jeffrey Gross, DPM
• Growth and Development LLC
• David R Gruen, MD
• Guardian Home Care of CT LLC
• Anna R Guarna, D.M.D.
• Charrisse Nicole Gudger
• Sofia Elena Gudiel
• Peter A Guglielmo, LCSW LADC

• Clinical Psychologist in Stamford, CT
• Providers in Stamford, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; 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.