Individual provider Active NPI

Ivan Grunberger, M.D.

  • Urology Physician
  • Brooklyn, NY
National Provider Identifier
1528062247
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
146673-1 Issued in NY
Practice address
38 6TH Ave FL 2
Brooklyn, NY 11217
Phone
(718) 230-7788
Fax
(718) 230-8017
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 146673-1 NY Primary

Addresses

Primary practice location

38 6TH Ave FL 2
Brooklyn, NY 11217

Mailing address

141 Combs Ave
Woodmere, NY 11598-1432
Phone (516) 569-0696

Other identifiers 1

IdentifierTypeStateIssuer
00962161MedicaidNY

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
I20051116000812 NY Practitioner - Urology 0840219002 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
New York University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

170 E 77TH St
New York, NY 10075-1912
Phone (212) 434-4856

Hospital & facility affiliations

  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
146673-1NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Urology CurrentSince Aug 12, 2019 Accepting new patients
Kings Physician Services, PC CurrentSince Nov 11, 2017 Accepting new patients
Kings Physician Services, PC CurrentSince Nov 11, 2017 Accepting new patients
Long Island College Hospital Urology Associates at Lich Urology Past Accepting new patients

Locations

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

322 Linden Blvd
Brooklyn, NY 11226
Phone (718) 230-7788

9438 58th Ave
Unit G3
Elmhurst, NY 11373
Phone (718) 393-3900

9438 58th Ave
Elmhurst, NY 11373
Phone (718) 393-3900

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

200 W 13th St
Fl 6
New York, NY 10011
Phone (646) 665-6784

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: igrunberger69174@northwell.direct-ci.com

Organizations & group practices 4

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.

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1528062247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 COMBS AVE",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981432",
            "telephone_number": "516-569-0696",
            "fax_number": "516-569-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 6TH AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11217",
            "telephone_number": "718-230-7788",
            "fax_number": "718-230-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNBERGER",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "146673-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00962161",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.