Active NPI
Stephen Anthony Grande, DC
- Chiropractor
- Cheektowaga, NY
National Provider Identifier
1730104423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X0036675
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002002351 | Other | NY | BCBS WESTERN NY |
| C036675 | Other | NY | W COMP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| X0036675 | NY | MD | Chiropractor |
| 3669 | NY | MD | Peer Specialist |
| 003667 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D'Youville College | Chiropractor | Current | Accepting new patients |
| D'Youville College | Chiropractor | Current | 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.
-
- Chiropractor
- Buffalo, NY
- NPI 1982967063
-
- Chiropractor
- Snyder, NY
- NPI 1649593229
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.