Individual provider Active NPI

Tatyana Bakhurets-Grasso, M.D

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1487016937
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
299787 Issued in NY
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-6000
NPI assigned
Mar 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 077098 CT
Pediatrics Physician 208000000X 299787 NY Primary

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240528000345 CT Practitioner - Pediatric Medicine 3870837826 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
077098CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Norwalk Community Health Center Inc CurrentSince Jun 24, 2024 Accepting new patients

Locations

120 Connecticut Ave
Norwalk, CT 06854
Phone (203) 851-1000

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

1401 Newkirk Ave
Brooklyn, NY 11226
Phone (718) 283-1600

Interoperability endpoints

  • Direct secure messaging: tatyana.bakhurets@nchc1.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CCDGCD
  • Direct secure messaging: tatyanabakhurets@mai.allscriptsdirect.net
  • Direct secure messaging: tatyana.bakhurets.p1@direct.mmc.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1487016937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKHURETS-GRASSO",
        "first_name": "TATYANA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "077098",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "299787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.