Individual provider Active NPI

Grace Bellotti, MD

  • Psychiatry Physician
  • Bronx, NY
National Provider Identifier
1508912981
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
089244 Issued in NY
Practice address
3248 Tierney Place
Private House
Bronx, NY 10465
Phone
(718) 822-1387
Fax
(718) 918-0215
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 089244 NY Primary

Addresses

Primary practice location

3248 Tierney Place
Private House
Bronx, NY 10465

Mailing address

3248 Tierney Place
Bronx, NY 10465
Phone (718) 822-1387

Other identifiers 1

IdentifierTypeStateIssuer
00888573MedicaidNY

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
089244NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508912981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 TIERNEY PLACE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10465",
            "telephone_number": "718-822-1387",
            "fax_number": "718-918-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 TIERNEY PLACE",
            "address_2": "PRIVATE HOUSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10465",
            "telephone_number": "718-822-1387",
            "fax_number": "718-918-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLOTTI",
        "first_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "089244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00888573",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.