Individual provider Active NPI

Robert Thomas Grant, M.D.

  • Plastic and Reconstructive Surgery Physician
  • New York, NY
National Provider Identifier
1619996360
Registry record updated Apr 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
159672 Issued in NY
Practice address
161 Fort Washington Ave FL 5
New York, NY 10032-3729
Phone
(212) 305-3103
Fax
(212) 305-9626
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 159672 NY Primary

Addresses

Primary practice location

161 Fort Washington Ave FL 5
New York, NY 10032-3729

Mailing address

PO Box 27036
New York, NY 10087-7036
Phone (212) 305-3103

Other identifiers 2

IdentifierTypeStateIssuer
159672OtherNYLICENSE
01237874MedicaidNY

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
I20091224000006 NY Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 9436299344 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Jun 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jun 1, 2018 Accepting new patients
The Trustees of Columbia University in the City of New York Plastic and Reconstructive Surgery CurrentSince Sep 1, 2013 Accepting new patients
The Trustees of Columbia University in the City of New York Plastic and Reconstructive Surgery Past Accepting new patients
Columbia Doctors of New Jersey, P. C. Past Accepting new patients

Locations

400 Kelby St
Ste 11
Fort Lee, NJ 07024

622 W 168th St
#14C
New York, NY 10032

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

161 Fort Washington Ave
#601
New York, NY 10032
Phone (212) 305-5868

161 Fort Washington Ave
Fl 5
New York, NY 10032
Phone (212) 305-4000

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523664000000",
    "number": "1619996360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27036",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100877036",
            "telephone_number": "212-305-3103",
            "fax_number": "212-305-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-305-3103",
            "fax_number": "212-305-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "ROBERT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "159672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "159672",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01237874",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.