Active NPI
Jaime L Grodzicki, MD
- Psychiatry Physician
- Valhalla, NY
National Provider Identifier
1437100922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 194641
- Practice address
- 95 Grasslands Road
Nymc Behavioral Health Center N326
Valhalla, NY 10595 - Phone
- (914) 493-7124
- Fax
- (914) 493-1015
- NPI assigned
- May 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 194641 | NY | Primary |
Addresses
Primary practice location
95 Grasslands Road
Nymc Behavioral Health Center N326
Valhalla, NY 10595
Mailing address
95 Grasslands Road
Nymc Behavioral Health Center N326
Valhalla, NY 10595
Phone (914) 493-7124
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01685276 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 194641 | NY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westchester Faculty Psychological Associates PC | Past | Accepting new patients | |
| Faculty Psychiatric Associates, PC | Psychiatry | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Child & Adolescent Psychiatry Physician
- Valhalla, NY
- NPI 1003864729
-
- Psychologist
- Valhalla, NY
- NPI 1528080603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207785600000",
"number": "1437100922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 GRASSLANDS ROAD",
"address_2": "NYMC BEHAVIORAL HEALTH CENTER N326",
"city": "VALHALLA",
"state": "NY",
"postal_code": "10595",
"telephone_number": "914-493-7124",
"fax_number": "914-493-1015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 GRASSLANDS ROAD",
"address_2": "NYMC BEHAVIORAL HEALTH CENTER N326",
"city": "VALHALLA",
"state": "NY",
"postal_code": "10595",
"telephone_number": "914-493-7124",
"fax_number": "914-493-1015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRODZICKI",
"first_name": "JAIME",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2008-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "194641",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01685276",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Valhalla, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.