Individual provider Active NPI

Inna Grishina, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1396852075
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
221566 Issued in NY
Practice address
4514 Beach 45TH St
Brooklyn, NY 11224-1002
Phone
(718) 663-8060
NPI assigned
Aug 25, 2006
Last updated
Apr 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 221566 NY Primary

Addresses

Primary practice location

4514 Beach 45TH St
Brooklyn, NY 11224-1002

Mailing address

4514 Beach 45TH St
Brooklyn, NY 11224-1002
Phone (718) 663-8060

Other identifiers 1

IdentifierTypeStateIssuer
02226786MedicaidNY

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
I20040419001278 NY Practitioner - Internal Medicine 3173518016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4514 Beach 45TH St
Brooklyn, NY 11224-1002
Phone (718) 663-8060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221566NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nebolit Medical PC Internal Medicine CurrentSince Mar 16, 2004 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ing9016@direct.nyp.org

Organizations & group practices 1

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1396852075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4514 BEACH 45TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112241002",
            "telephone_number": "718-663-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4514 BEACH 45TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112241002",
            "telephone_number": "718-663-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHINA",
        "first_name": "INNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "221566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02226786",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.