Individual provider Active NPI

Ruby Grewal, MD

  • Psychiatry Physician
  • Erie, PA
National Provider Identifier
1780178863
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD476865 Issued in PA
Practice address
650 East Ave
Erie, PA 16503-1535
Phone
(814) 455-5505
Fax
(814) 455-5515
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 57.246222 OH
Psychiatry Physician 2084P0800X MD476865 PA Primary

Addresses

Primary practice location

650 East Ave
Erie, PA 16503-1535

Mailing address

63 Pitt St
Sharon, PA 16146-2102
Phone (724) 342-3002

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220816003503 PA Practitioner - Psychiatry 3779839204 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57.246222OHMDPsychiatry Physician
MD476865PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Network CurrentSince Aug 1, 2022 Accepting new patients
Primary Health Network CurrentSince Aug 1, 2022 Accepting new patients

Locations

650 East Ave
Erie, PA 16503
Phone (814) 455-5505

2000 Green St
Farrell, PA 16121
Phone (724) 342-6600

63 Pitt St
Sharon, PA 16146
Phone (724) 342-6604

Interoperability endpoints

  • Direct secure messaging: rubygrewal@primaryhn.medalliesdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780178863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 PITT ST",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161462102",
            "telephone_number": "724-342-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 EAST AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165031535",
            "telephone_number": "814-455-5505",
            "fax_number": "814-455-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "RUBY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "57.246222",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD476865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.