Individual provider Active NPI

Josephine Gramarosso, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Wading River, NY
National Provider Identifier
1669916672
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F403037 Issued in NY
Practice address
2042 N Country Rd
Wading River, NY 11792-1639
Phone
(631) 257-7968
NPI assigned
Dec 9, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230210001022 OR Practitioner - Nurse Practitioner 0749652188 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
492681NYMDRegistered Nurse
F403037NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cynthia Gulick, PC CurrentSince Mar 6, 2023 Accepting new patients
My Other Me PastSince Mar 6, 2023 Accepting new patients

Locations

11900 SW Greenburg Rd
Tigard, OR 97223
Phone (503) 386-5424

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 492681 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F403037 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

2042 N Country Rd
Wading River, NY 11792-1639

Mailing address

2042 N Country Rd
Wading River, NY 11792-1639
Phone (631) 257-7968

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 6, 2022.

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1669916672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 N COUNTRY RD",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117921639",
            "telephone_number": "631-257-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2042 N COUNTRY RD",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117921639",
            "telephone_number": "631-257-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMAROSSO",
        "first_name": "JOSEPHINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "492681",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F403037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wading River, NY

Sources for this page

Verify at the official NPI Registry.