Individual provider Active NPI

Andrew M Grunwald, MD

  • Cardiovascular Disease Physician
  • New Hyde Park, NY
National Provider Identifier
1477635084
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
1277641 Issued in NY
Practice address
3003 New Hyde Park Road #406
New Hyde Park, NY 11042
Phone
(516) 358-5401
Fax
(516) 358-5403
NPI assigned
Oct 20, 2006
Last updated
Jun 29, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 1277641 NY Primary

Addresses

Primary practice location

3003 New Hyde Park Road #406
New Hyde Park, NY 11042

Mailing address

3003 New Hyde Park Road #406
New Hyde Park, NY 11042
Phone (516) 358-5401

Other identifiers 1

IdentifierTypeStateIssuer
00685630MedicaidNY

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
I20060303000538 NY Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5092721738 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
New York Medical College, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347

1000 N Village Ave
Rockville Center, NY 11570-1000

310 E Shore Rd
Suite 104
Great Neck, NY 11023-2432
Phone (516) 829-9550

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1277641NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newyork-Presbyterian/Queens Cardiovascular Disease CurrentSince Apr 17, 2012 Accepting new patients
New York University Cardiovascular Disease CurrentSince Aug 1, 2015 Accepting new patients
CHS Physician Partners, P.C Cardiovascular Disease CurrentSince Jul 13, 2020 Accepting new patients
New York University Cardiovascular Disease CurrentSince Aug 1, 2015 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Newyork-Presbyterian-Queens CurrentSince Apr 17, 2012 Accepting new patients
Weill Medical College of Cornell Cardiovascular Disease PastSince Oct 18, 1999 Accepting new patients

Locations

17561 Hillside Ave
Ste 402
Jamaica, NY 11432
Phone (718) 670-1021

27005 76th Ave
North New Hyde Pk, NY 11040

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: agrunwald23217@direct-chsli.net

Organizations & group practices 8

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 1

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1477635084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 NEW HYDE PARK ROAD #406",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "516-358-5401",
            "fax_number": "516-358-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 NEW HYDE PARK ROAD #406",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "516-358-5401",
            "fax_number": "516-358-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNWALD",
        "first_name": "ANDREW",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "1277641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00685630",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.