Individual provider Active NPI

Olga Gruscinska, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1457580052
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
265345 Issued in NY
Practice address
408 W 57TH St Apt 7L
New York, NY 10019-3012
Phone
(646) 410-2227
NPI assigned
Jul 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD003471 NY
Internal Medicine Physician 207R00000X MD437523 PA
Internal Medicine Physician 207R00000X 265345 NY Primary

Addresses

Primary practice location

408 W 57TH St Apt 7L
New York, NY 10019-3012

Mailing address

408 W 57TH St Apt 7L
New York, NY 10019-3012
Phone (646) 410-2227

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
I20111020000373 NY Practitioner - Internal Medicine 4981758323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prominis Medical Services PCGroup PAC ID 9537124441, 43 clinicians

Practice addresses (Care Compare)

130 Brighton Beach Ave
Suite 3
Brooklyn, NY 11235-8067
Phone (718) 942-5385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD003471NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RLD Medical Services, PC Internal Medicine CurrentSince Aug 1, 2012 Accepting new patients
Forest Hills Dermatology Group PLLC CurrentSince Sep 1, 2012 Accepting new patients
Prominis Medical Services PC Internal Medicine CurrentSince Dec 1, 2025 Accepting new patients
St John'S Medical Services PC Internal Medicine Past Accepting new patients
Comprehensive Women'S Health of N.Y. PLLC PastSince Jan 9, 2009 Accepting new patients

Locations

332 DeKalb Ave
Brooklyn, NY 11205
Phone 7185825252101

130 Brighton Beach Ave
Ste 3
Brooklyn, NY 11235
Phone (718) 942-5385

6829 Myrtle Ave
Glendale, NY 11385
Phone (718) 366-2242

6051 Fresh Pond Rd
Maspeth, NY 11378
Phone (718) 386-6642

140 Beach 114th St
Rockaway Park, NY 11694
Phone (718) 945-4600

45 S Route 9W
Ste 41
West Haverstraw, NY 10993
Phone (845) 428-9006

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1457580052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 W 57TH ST APT 7L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193012",
            "telephone_number": "646-410-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W 57TH ST APT 7L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193012",
            "telephone_number": "646-410-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSCINSKA",
        "first_name": "OLGA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "MD003471",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD437523",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "265345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.