Individual provider Active NPI

Joanna Elizabeth Grater, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Jersey City, NJ
National Provider Identifier
1710374707
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
25MA11115700 Issued in NJ
Practice address
1825 John F Kennedy Blvd
Jersey City, NJ 07305-2106
Phone
(201) 204-0044
NPI assigned
Apr 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 25MA11115700 NJ Primary

Addresses

Primary practice location

1825 John F Kennedy Blvd
Jersey City, NJ 07305-2106

Mailing address

1825 John F Kennedy Blvd
Jersey City, NJ 07305-2106
Phone (201) 204-0044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240508002848 NJ Practitioner - Pediatric Medicine 2860730983 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children' Specialized Hospital CurrentSince Apr 3, 2024 Accepting new patients
Children'S Specialized Hospital CurrentSince Apr 3, 2024 Accepting new patients

Locations

1825 John F Kennedy Blvd
Jersey City, NJ 07305
Phone (201) 402-3461

150 New Providence Rd
Mountainside, NJ 07092

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

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.

NPI Registry JSON

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1710374707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 JOHN F KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073052106",
            "telephone_number": "201-204-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 JOHN F KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073052106",
            "telephone_number": "201-204-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRATER",
        "first_name": "JOANNA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-17",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NJ",
            "license": "25MA11115700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.