Organization Active NPI

Howard Grill MD and David Grill MD

  • Medical Specialty Clinic/Center
  • Freeport, NY
National Provider Identifier
1447455076
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
124847 Issued in NY
Legal business name
HOWARD GRILL MD AND DAVID GRILL MD
Practice address
121 S Ocean Ave
1
Freeport, NY 11520-4452
Phone
(516) 379-5005
Fax
(516) 379-9053
NPI assigned
Jun 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Howard E Grill, MD
Title
Partner
Phone
(516) 379-5005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 124847 NY Primary

Addresses

Primary practice location

121 S Ocean Ave
1
Freeport, NY 11520-4452

Mailing address

121 S Ocean Ave
1
Freeport, NY 11520-4452
Phone (516) 379-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110922000442 NY Part B Supplier - Clinic/Group Practice 8729259775 Receives reassigned benefits from 1 practitioner
Practice locations: Freeport, NY

National Provider Directory

National Provider Directory

Locations

121 S Ocean Ave
Ste 1
Freeport, NY 11520
Phone (516) 379-5005

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447455076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S OCEAN AVE",
            "address_2": "1",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115204452",
            "telephone_number": "516-379-5005",
            "fax_number": "516-379-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S OCEAN AVE",
            "address_2": "1",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115204452",
            "telephone_number": "516-379-5005",
            "fax_number": "516-379-9053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWARD GRILL MD AND DAVID GRILL MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRILL",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "516-379-5005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "124847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.