Gracie Nicole Medvinsky, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F383434 Issued in NY

Practice address

1317 Third Avenue
Floor 8
New York, NY 10021-2962

Phone

(212) 434-6400

Fax

(212) 249-1269

NPI assigned

Aug 11, 2022

Last updated

Nov 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Gracie Nicole Perez Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: nmedvinsky61039@northwell.direct-ci.com

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.

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  • NPI 1053688572
  Medicare reassignment
• North Shore - Lij Medical PC

  dba NSLIJ Medical In Queens

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1760110316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 THIRD AVENUE",
            "address_2": "FLOOR 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212962",
            "telephone_number": "212-434-6400",
            "fax_number": "212-249-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 THIRD AVENUE",
            "address_2": "FLOOR 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212962",
            "telephone_number": "212-434-6400",
            "fax_number": "212-249-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDVINSKY",
        "first_name": "GRACIE",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACIE",
            "last_name": "PEREZ",
            "middle_name": "NICOLE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Enrico Meduri
• Elvira Maria Medus, LCSW
• Michaela A Medved
• Eugene Medvedev, MD
• Medvidi Health PC
• Irene Carol Medwid, D.C.
• Yuliya Medzhitova, PHD
• Caroline Meecham
• Meed Medical, PLLC
• Rita Goldwasser Meed, PHD

• Pediatric Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.