Organization Active NPI

Simple Healthcare, NP in Family Health, PLLC

Doing business as Simple Healthcare

  • Family Medicine Physician
  • Albany, NY
National Provider Identifier
1760263354
Registry record updated Dec 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SIMPLE HEALTHCARE, NP IN FAMILY HEALTH, PLLC
Doing business as
Simple Healthcare
Practice address
418 Broadway Ste R
Albany, NY 12207-2922
Phone
(646) 907-9994
NPI assigned
Oct 10, 2023
Last updated
Dec 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2023

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

Authorized official

Name
Dr. Chenelle Grant, DNP, FNP-BCNPI 1801441399
Title
Provider
Phone
(646) 907-9994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

418 Broadway Ste R
Albany, NY 12207-2922

Mailing address

418 Broadway Ste R
Albany, NY 12207-2922

Other identifiers 3

IdentifierTypeStateIssuer
1376028514MedicaidNY
1801441399MedicaidNY
1750806204MedicaidNY

Other names 1

  • Simple Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241213000385 NY Part B Supplier - Clinic/Group Practice 6204362239 Receives reassigned benefits from 3 practitioners
Practice locations: Hauppauge, NY

National Provider Directory

National Provider Directory

Locations

6143 186th St
Ste 489
Fresh Meadows, NY 11365

35 Arkay Dr
Hauppauge, NY 11788
Phone (888) 674-2742

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702684800000",
    "number": "1760263354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 BROADWAY STE R",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 BROADWAY STE R",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072922",
            "telephone_number": "646-907-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLE HEALTHCARE, NP IN FAMILY HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-12-16",
        "certification_date": "2023-12-16",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "CHENELLE",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "646-907-9994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376028514",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801441399",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750806204",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simple Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.