Individual provider Active NPI

Patrice Grant, O.D.

  • Optometrist
  • Bronx, NY
National Provider Identifier
1750738159
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008455 Issued in NY
Practice address
85 W Burnside Ave
Bronx, NY 10453
Phone
(718) 716-4400
NPI assigned
May 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008455 NY Primary

Addresses

Primary practice location

85 W Burnside Ave
Bronx, NY 10453

Mailing address

85 W Burnside Ave
Bronx, NY 10453-4015

Other practice location 1

800 Poly Pl
Brooklyn, NY 11209-7104
Phone (718) 836-6600

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170928000197 NY Practitioner - Optometry 8820362973 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008455NYMDOptometrist
008455NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Heights Health Center, Inc. CurrentSince Aug 28, 2017 Accepting new patients
Morris Heights Health Center, Inc. CurrentSince Aug 28, 2017 Accepting new patients
Morris Heights Health Center, Inc. Past Accepting new patients

Locations

85 W Burnside Ave
Bronx, NY 10453
Phone (718) 483-1270

Interoperability endpoints

  • Direct secure messaging: patrice.grant.p1@direct.mhhc.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1750738159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 W BURNSIDE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 W BURNSIDE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10453",
            "telephone_number": "718-716-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Poly Pl",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112097104",
            "country_code": "US",
            "telephone_number": "718-836-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "PATRICE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.