Mark Grudman, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

192167 Issued in NY

Practice address

393 Sunrise Highway
West Babylon, NY 11704-5909

Phone

(631) 228-5540

Fax

(631) 396-6861

NPI assigned

May 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

State University of New York at Stony Brook, School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Cardiac Ekg Interpretation, P. C.Group PAC ID 2466345103, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332
• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286
• St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182
• St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246
• NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: mgrudman40912@direct-chsli.net
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71355
• Direct secure messaging: mark.grudman@amityvilleheartcenter.directbygreenway.com

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.

• Cardiac Ekg Interpretation, P. C.

  • Cardiovascular Disease Physician
  • West Islip, NY
  • NPI 1386665644
  Medicare reassignment Care Compare group NPD
• CHS Physician Partners, PC

  • Interventional Cardiology Physician
  • Fresh Meadows, NY
  • NPI 1407089345
  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Cardiovascular Disease

  Medicare reassignment NPD
• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725
  NPD
• Mathew T. Chengot MD PC

  • Specialist
  • Amityville, NY
  • NPI 1467670661
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  Care Compare affiliation
• NYU Langone Hospitals

  • Rehabilitation Hospital Unit
  • New York, NY
  • NPI 1275632895
  Care Compare affiliation
• NYU Langone Hospitals

  • Ambulance
  • Brooklyn, NY
  • NPI 1346614443

  Hospital

  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • Mineola, NY
  • NPI 1427616002
  Care Compare affiliation
• NYU Langone Hospitals

  • Oncology Clinic/Center
  • New York, NY
  • NPI 1437230034

  Hospital

  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1619341716
  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • New York, NY
  • NPI 1669578324
  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • New York, NY
  • NPI 1801992631
  Care Compare affiliation
• St Charles Hospital Corp

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1164481529
  Care Compare affiliation
• St. Francis Hospital

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1043279565
  Care Compare affiliation
• Wsnchs North, Inc.

  • General Acute Care Hospital
  • Bethpage, NY
  • NPI 1013998426
  Care Compare affiliation

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684540800000",
    "number": "1750330049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 SUNRISE HIGHWAY",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117045909",
            "telephone_number": "631-228-5540",
            "fax_number": "631-396-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 SUNRISE HIGHWAY",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117045909",
            "telephone_number": "631-228-5540",
            "fax_number": "631-396-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUDMAN",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2023-05-20",
        "certification_date": "2023-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "192167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01762716",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Dental Smiles
• Margaret Grady
• Kim Ansonia Gregg, RN
• Michael Vincent Gregorio, DDS
• Karine Grigoryants, MD
• Nafissatou Gueye, RN
• Guida & Savino, LLP
• Anthony A. Guida, MD
• Michael Anthony Guida, M.D.
• Amanda Rose Gundy, LPN

• Cardiovascular Disease Physician in West Babylon, NY
• Providers in West Babylon, NY by specialty
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.