Individual provider Active NPI

Selina Samuelle Grippo, FNP-C

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1396427761
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
873582 Issued in NY
Practice address
2633 Broadway
New York, NY 10025-5022
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Aug 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Nurse Practitioner 363LC1500X 873582 NY
Family Nurse Practitioner 363LF0000X 873582 NY Primary

Addresses

Primary practice location

2633 Broadway
New York, NY 10025-5022

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

36-11 21st St
Long Island City, NY 11106-4505
Phone (718) 482-7772

Other practice location 2

999 Blake Ave
Brooklyn, NY 11208-3535
Phone (718) 277-8303

Other practice location 3

255 E Houston St
New York, NY 10002-1013
Phone (212) 477-1120

Other practice location 4

511 W 157TH St
New York, NY 10032-5058
Phone (212) 781-7979

Other practice location 5

81 W 115th St
New York, NY 10026-3138
Phone (212) 426-0088

Other practice location 6

350 Grand St Rm 240
New York, NY 10002-4629
Phone (212) 634-7550 ext. 7556

Other practice location 7

89-44 164th St
Jamaica, NY 11432-6103
Phone (718) 523-2123

Other practice location 8

975 Westchester Ave
Bronx, NY 10459-3204
Phone (718) 320-4466

Other practice location 9

94-98 Manhattan Avenue
Brooklyn, NY 11206-2505
Phone (718) 388-0390

Other practice location 10

4215 3rd Ave Fl 2
Bronx, NY 10457-4501
Phone (718) 294-5891

Other practice location 11

504 W 158th St Fl 5
New York, NY 10032-7202
Phone (917) 521-3130 ext. 3130

Other practice location 12

2581 Atlantic Ave
Brooklyn, NY 11207-2412
Phone (718) 495-6700

Other practice location 13

1167 Nostrand Ave
Brooklyn, NY 11225-5417
Phone (718) 778-0198

Other names 1

  • Selina Samuelle Sta Ana Former name

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
I20240118002238 NY Practitioner - Nurse Practitioner 0547612269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
One Medical of Ny PCGroup PAC ID 3274713110, 72 clinicians
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

2633 Broadway
New York, NY 10025-5022
Phone (888) 663-6331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
873582NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Mar 7, 2025 Accepting new patients
One Medical of Ny, P.C. CurrentSince Jan 1, 2026 Accepting new patients
Montefiore Medical Center Current Accepting new patients
Montefiore Medical Center CurrentSince Mar 7, 2025 Accepting new patients
Community Healthcare Network, Inc. Past Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients

Locations

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

111 E 210th St
Bronx, NY 10467

2633 Broadway
New York, NY 10025
Phone (212) 321-7001

919 3rd Ave
Ste 105
New York, NY 10022
Phone (212) 530-0650

Networks

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

Organizations & group practices 6

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": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1396427761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791",
            "fax_number": "415-520-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255022",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36-11 21st St",
            "address_purpose": "LOCATION",
            "city": "Long Island City",
            "state": "NY",
            "postal_code": "111064505",
            "country_code": "US",
            "telephone_number": "718-482-7772",
            "fax_number": "718-482-9648",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "999 Blake Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112083535",
            "country_code": "US",
            "telephone_number": "718-277-8303",
            "fax_number": "718-277-4795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "255 E Houston St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100021013",
            "country_code": "US",
            "telephone_number": "212-477-1120",
            "fax_number": "212-477-8957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "511 W 157TH ST",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100325058",
            "country_code": "US",
            "telephone_number": "212-781-7979",
            "fax_number": "212-781-7963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "81 W 115th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100263138",
            "country_code": "US",
            "telephone_number": "212-426-0088",
            "fax_number": "212-426-8367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Grand St Rm 240",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100024629",
            "country_code": "US",
            "telephone_number": "212-634-7550 x7556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "89-44 164th St",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114326103",
            "country_code": "US",
            "telephone_number": "718-523-2123",
            "fax_number": "718-523-5833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "975 Westchester Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104593204",
            "country_code": "US",
            "telephone_number": "718-320-4466",
            "fax_number": "718-991-3829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "94-98 Manhattan Avenue",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112062505",
            "country_code": "US",
            "telephone_number": "718-388-0390",
            "fax_number": "718-486-5741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4215 3rd Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104574501",
            "country_code": "US",
            "telephone_number": "718-294-5891",
            "fax_number": "718-294-2468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "504 W 158th St Fl 5",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100327202",
            "country_code": "US",
            "telephone_number": "917-521-3130 x3130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2581 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112072412",
            "country_code": "US",
            "telephone_number": "718-495-6700",
            "fax_number": "646-988-2840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1167 Nostrand Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112255417",
            "country_code": "US",
            "telephone_number": "718-778-0198",
            "fax_number": "718-221-8169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIPPO",
        "first_name": "SELINA SAMUELLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "NY",
            "license": "873582",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "873582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SELINA SAMUELLE",
            "last_name": "STA ANA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.