Organization Active NPI

Modern Healthcare Family Health NP PLLC

  • Home Health Agency
  • Bronx, NY
National Provider Identifier
1679455083
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MODERN HEALTHCARE FAMILY HEALTH NP PLLC
Practice address
5800 Arlington Ave Apt 10W
Bronx, NY 10471-1413
Phone
(917) 405-5490
NPI assigned
Jul 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Genesis Grullon, NURSE PRACTITIONERNPI 1477947877
Title
Owner
Phone
(917) 405-5490

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Nursing Care Agency 251J00000X

Addresses

Primary practice location

5800 Arlington Ave Apt 10W
Bronx, NY 10471-1413

Mailing address

5800 Arlington Ave Apt 10W
Bronx, NY 10471-1413
Phone (917) 405-5490

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251004000185 NY Part B Supplier - Clinic/Group Practice 4183120439 Receives reassigned benefits from 1 practitioner
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1753315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1679455083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 ARLINGTON AVE APT 10W",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711413",
            "telephone_number": "917-405-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 ARLINGTON AVE APT 10W",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711413",
            "telephone_number": "917-405-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN HEALTHCARE FAMILY HEALTH NP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "GRULLON",
        "authorized_official_first_name": "GENESIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-405-5490",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.