Active NPI
Mark Thomas Grunert, PA-C
- Physician Assistant
- Albany, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 024873
- Practice address
- 319 S Manning Blvd
Albany, NY 12208-1742 - Phone
- (518) 438-1019
- NPI assigned
- Feb 18, 2020
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 024873 | NY | Primary |
Addresses
Primary practice location
319 S Manning Blvd
Albany, NY 12208-1742
Mailing address
PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634
Other practice location 1
4 Executive Park Dr Ste 2
Albany, NY 12203-3717
Phone (518) 489-7494
Other practice location 2
2 Empire Dr Ste 100
Rensselaer, NY 12144-5730
Phone (518) 286-4899
Other practice location 3
315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-8600
Other practice location 4
1205 Troy Schenectady Rd Ste 101
Latham, NY 12110-1074
Phone (518) 348-3176
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | payer.credentialing@sphp.com | Direct |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Tufts University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
43 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-3277
47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samaritan Hospital of Troy, New York | Physician Assistant | Current | Accepting new patients |
| Albany Medical College | Current | Accepting new patients | |
| St. Peter's Hospital of the City of Albany | Physician Assistant | Current | Accepting new patients |
| Albany Medical College | Current | Accepting new patients | |
| St. Peter's Hospital of the City of Albany | Physician Assistant | Current | Accepting new patients |
| Wellnow Urgent Care, PC | Current | Accepting new patients | |
| St. Peter's Health Partners Medical Associates, P.C. | Physician Assistant | Current | Accepting new patients |
| Albany Medical College | Physician Assistant | Past | Accepting new patients |
Locations
315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852
4 Executive Park Dr
Ste 2
Albany, NY 12203
Phone (518) 435-1231
43 New Scotland Ave
#139
Albany, NY 12208
Phone (518) 262-3131
47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773
446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496
71 Prospect Ave
Hudson, NY 12534
Phone (518) 262-3773
117 Marys Ave
Ste 202
Kingston, NY 12401
Phone (845) 338-1717
7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064
2 Empire Dr
Ste 100
Rensselaer, NY 12144
Phone (518) 286-4899
2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331
2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300
1301 River St
Ste 204
Valatie, NY 12184
Phone (518) 392-8600
Interoperability endpoints
- ms_mgrunert@landmarkhealth-direct.org
- payer.credentialing@sphp.com
Organizations & group practices 8
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.
-
- Allergy & Immunology Physician
- Albany, NY
- NPI 1497921688
-
- General Acute Care Hospital
- Troy, NY
- NPI 1043267727
Physician Assistant
-
- Multi-Specialty Clinic/Center
- Albany, NY
- NPI 1750626834
Physician Assistant
-
dba St. Peter's Hospital
- General Acute Care Hospital
- Albany, NY
- NPI 1518042357
Physician Assistant
-
dba WellNow Urgent Care
- Urgent Care Clinic/Center
- Liverpool, NY
- NPI 1669825162
-
dba Albany Med EmUrgent Care
- Urgent Care Clinic/Center
- Albany, NY
- NPI 1386038925
-
- General Acute Care Hospital
- Albany, NY
- NPI 1497701106
Physician Assistant
-
dba Albany Medical College Department of Medicine
- Allergy & Immunology Physician
- Albany, NY
- NPI 1386689248
Physician Assistant
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Ambulatory Surgical Clinic/Center
- Niskayana, NY
- NPI 1154973071
Hospital
-
- General Acute Care Hospital
- Albany, NY
- NPI 1376577247
-
dba Albany Medical Center South Clinical Campus
- General Acute Care Hospital
- Albany, NY
- NPI 1811917461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1639702772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14890",
"city": "ALBANY",
"state": "NY",
"postal_code": "122124890",
"telephone_number": "518-525-5634",
"fax_number": "518-649-4094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 S MANNING BLVD",
"city": "ALBANY",
"state": "NY",
"postal_code": "122081742",
"telephone_number": "518-438-1019"
}
],
"practiceLocations": [
{
"address_1": "4 Executive Park Dr Ste 2",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "122033717",
"country_code": "US",
"telephone_number": "518-489-7494",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 Empire Dr Ste 100",
"address_purpose": "LOCATION",
"city": "Rensselaer",
"state": "NY",
"postal_code": "121445730",
"country_code": "US",
"telephone_number": "518-286-4899",
"fax_number": "518-286-4859",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "315 S Manning Blvd",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "122081707",
"country_code": "US",
"telephone_number": "518-525-8600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1205 Troy Schenectady Rd Ste 101",
"address_purpose": "LOCATION",
"city": "Latham",
"state": "NY",
"postal_code": "121101074",
"country_code": "US",
"telephone_number": "518-348-3176",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRUNERT",
"first_name": "MARK",
"middle_name": "THOMAS",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-18",
"last_updated": "2023-03-07",
"certification_date": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "024873",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "payer.credentialing@sphp.com",
"affiliation": "N",
"endpointDescription": "SPHP Payer Credentialing",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "319 S Manning Blvd",
"city": "Albany",
"state": "NY",
"country_code": "US",
"postal_code": "122081742",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.