Individual provider Active NPI

Deborah Gruber, MD

  • Neurology Physician
  • Lake Success, NY
National Provider Identifier
1649218447
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
209409 Issued in NY
Practice address
2 Pro Health PLZ
Lake Success, NY 11042-1111
Phone
(516) 622-6105
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 209409 NY Primary

Addresses

Primary practice location

2 Pro Health PLZ
Lake Success, NY 11042-1111

Mailing address

2 Pro Health PLZ
Lake Success, NY 11042-1111

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
I20041228000403 NY Practitioner - Neurology 1951369602 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Icahn School of Medicine at Mount Sinai, 1995
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)

100 E 77TH St
New York, NY 10075-1850
Phone (212) 434-2140

Hospital & facility affiliations

  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209409NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Sep 3, 2011 Accepting new patients
New York University CurrentSince Sep 3, 2011 Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 14, 2017 Accepting new patients
Prohealth Care Associates, LLP Past Accepting new patients
Optum Urgent Care, PLLC Past Accepting new patients
North Shore University Hospital Past Accepting new patients

Locations

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

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

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

130 E 77th St
Fl 8
New York, NY 10075
Phone (212) 434-2150

160 E 34th St
New York, NY 10016
Phone (212) 731-5180

450 Lakeville Rd
North New Hyde Park, NY 11042
Phone (516) 321-3000

2 Pro Health Plz
North New Hyde Pk, NY 11042
Phone (516) 608-6820

300 Community Dr
Plandome, NY 11030

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: dgruber67000@northwell.direct-ci.com

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.

Hospital & facility affiliations 2

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1649218447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PRO HEALTH PLZ",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "110421111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PRO HEALTH PLZ",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "110421111",
            "telephone_number": "516-622-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "DEBORAH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "209409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Success, NY

Sources for this page

Verify at the official NPI Registry.