Individual provider Active NPI

Svetlana Grinberg

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1396982021
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008575 Issued in NY
Practice address
625 E Fordham Rd
Bronx, NY 10458-5049
Phone
(718) 933-1900
Fax
(718) 933-5321
NPI assigned
Jan 16, 2009
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 008575 NY Primary

Addresses

Primary practice location

625 E Fordham Rd
Bronx, NY 10458-5049

Mailing address

625 E Fordham Rd
Bronx, NY 10458-5049
Phone (718) 933-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040323001976 NY Practitioner - Physician Assistant 7911898341 Reassigns benefits to 1 organization
I20110817000249 NJ Practitioner - Physician Assistant 7911898341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daniel Korya MD LLCGroup PAC ID 8820339310, 10 clinicians
Medalliance Medical Health Services IncGroup PAC ID 4789633678, 19 clinicians

Practice addresses (Care Compare)

21 Lincoln Ave
Elmwood Park, NJ 07407-1614
Phone (551) 277-4441

625 E Fordham Rd
Bronx, NY 10458-5049
Phone (718) 933-1900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SK Neurology PC PastSince Nov 17, 2019 Accepting new patients
Radius Telemed, LLC PastSince Apr 26, 2020 Accepting new patients

Organizations & group practices 5

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 3

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": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1396982021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E FORDHAM RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585049",
            "telephone_number": "718-933-1900",
            "fax_number": "718-933-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E FORDHAM RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585049",
            "telephone_number": "718-933-1900",
            "fax_number": "718-933-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINBERG",
        "first_name": "SVETLANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.