NPIMap

Organization Active NPI

Grover Med LLC

  • Prosthetic/Orthotic Supplier
  • Hicksville, NY
National Provider Identifier
1649807454
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
GROVER MED LLC
Practice address
100 Newbridge Rd Ste 6
Hicksville, NY 11801-3948
Phone
(516) 882-7473
Fax
(516) 530-9478
NPI assigned
Mar 24, 2020
Last updated
Apr 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Authorized official

Name
Dr. Ravi GroverNPI 1134772320
Title
Ceo
Phone
(516) 882-7473

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Vehicle Modifications Contractor 171WV0202X NU
Assistive Technology Supplier Rehabilitation Counselor 225CA2500X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU
Customized Equipment (DME) 332BC3200X NU
Prosthetic/Orthotic Supplier 335E00000X NU Primary

Addresses

Primary practice location

100 Newbridge Rd Ste 6
Hicksville, NY 11801-3948

Mailing address

1077 Iris PL
Westbury, NY 11590-5610
Phone (917) 299-6051

Other identifiers 2

IdentifierTypeStateIssuer
1134772320OtherNYCMS
06211930MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200403002139 NY DME Supplier - Medical Supply Company 5092144576 Practice locations: Hicksville, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1649807454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 IRIS PL",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905610",
            "telephone_number": "917-299-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NEWBRIDGE RD STE 6",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013948",
            "telephone_number": "516-882-7473",
            "fax_number": "516-530-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROVER MED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-24",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "GROVER",
        "authorized_official_first_name": "RAVI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "516-882-7473",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "171WV0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Vehicle Modifications",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225CA2500X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor, Assistive Technology Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS",
            "identifier": "1134772320",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06211930",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.