Individual provider Active NPI

Baljinder Kaur Grewal, M.D.

  • Family Medicine Physician
  • Nesconset, NY
National Provider Identifier
1619248135
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
265920-1 Issued in NY
Practice address
465 Smithtown Blvd
Nesconset, NY 11767-2421
Phone
(631) 767-6700
NPI assigned
Jan 13, 2012
Last updated
Aug 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA09037800 NJ
Family Medicine Physician 207Q00000X 265920-1 NY Primary

Addresses

Primary practice location

465 Smithtown Blvd
Nesconset, NY 11767-2421

Mailing address

8414 246TH St
Bellerose, NY 11426-1725
Phone (516) 993-6393

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
I20120820000328 NY Practitioner - Family Practice 8325294705 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

54 Heather LN
Levittown, NY 11756-3334
Phone (516) 735-1116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09037800NJMDFamily Medicine Physician
265920-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Purnima M. Kothari, Physician, PC CurrentSince Jan 1, 2015 Accepting new patients
DGN Family Medicine, PLLC, CurrentSince Jan 1, 2014 Accepting new patients
New York Cardiovascular Care P.C. PastSince Aug 4, 2015 Accepting new patients
Excel Urgent Care of East Northport, PLLC PastSince Sep 1, 2012 Accepting new patients
Excel Urgent Care of NHP PLLC PastSince Mar 1, 2013 Accepting new patients

Locations

4609 5th Ave
Brooklyn, NY 11220
Phone (718) 436-4781

54 Heather Ln
Levittown, NY 11756
Phone (516) 735-1116

12412 101st Ave
South Richmond Hl, NY 11419
Phone (718) 487-4115

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18629/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1619248135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8414 246TH ST",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261725",
            "telephone_number": "516-993-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 SMITHTOWN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672421",
            "telephone_number": "631-767-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "BALJINDER",
        "middle_name": "KAUR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09037800",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "265920-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nesconset, NY

Sources for this page

Verify at the official NPI Registry.