Individual provider Active NPI

Stephen Anthony Grande, DC

  • Chiropractor
  • Cheektowaga, NY
National Provider Identifier
1730104423
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X0036675 Issued in NY
Practice address
3685 Harlem Rd
Cheektowaga, NY 14215
Phone
(716) 834-4950
Fax
(716) 834-0219
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X0036675 NY Primary

Addresses

Primary practice location

3685 Harlem Rd
Cheektowaga, NY 14215

Mailing address

3685 Harlem Rd
Cheektowaga, NY 14215
Phone (716) 834-4950

Other identifiers 2

IdentifierTypeStateIssuer
002002351OtherNYBCBS WESTERN NY
C036675OtherNYW COMP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080821000445 NY Practitioner - Chiropractic 0446325666 Reassigns benefits to 2 organizations
Practice locations: Cheektowaga, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3685 Harlem Rd
Cheektowaga, NY 14215-2046
Phone (716) 834-4950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X0036675NYMDChiropractor
3669NYMDPeer Specialist
003667NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
D'Youville College Chiropractor CurrentSince Oct 12, 2014 Accepting new patients
D'Youville College Chiropractor CurrentSince Oct 12, 2014 Accepting new patients
Lifecare Chiropractic, PC Chiropractor Past Accepting new patients

Locations

301 Connecticut St
#202
Buffalo, NY 14213
Phone (716) 923-4617

320 Porter Ave
Buffalo, NY 14201
Phone (716) 829-7991

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

Organizations & group practices 3

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1730104423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3685 HARLEM RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "14215",
            "telephone_number": "716-834-4950",
            "fax_number": "716-834-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3685 HARLEM RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "14215",
            "telephone_number": "716-834-4950",
            "fax_number": "716-834-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDE",
        "first_name": "STEPHEN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0036675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS WESTERN NY",
            "identifier": "002002351",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "W COMP",
            "identifier": "C036675",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.