Active NPI
Kanwarpaul S. Grewal Medical PLLC
- Orthopaedic Surgery of the Spine Physician
- East Meadow, NY
National Provider Identifier
1780244798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery of the Spine Physician
- Legal business name
- KANWARPAUL S. GREWAL MEDICAL PLLC
- Practice address
- 30 Merrick Ave Ste 103
East Meadow, NY 11554-1580 - Phone
- (516) 743-9450
- Fax
- (516) 743-9451
- NPI assigned
- Jun 20, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kanwarpaul S Grewal, DO
- Title
- Owner
- Phone
- (516) 743-9450
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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | |||
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | Primary | ||
| Orthopaedic Foot and Ankle Surgery Physician | 207XX0004X | |||
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | |||
| Orthopaedic Trauma Physician | 207XX0801X |
Addresses
Primary practice location
30 Merrick Ave Ste 103
East Meadow, NY 11554-1580
Mailing address
30 Merrick Ave Ste 103
East Meadow, NY 11554-1580
Phone (516) 743-9450
Other practice location 1
150 Sunrise Hwy Ste Ll-22
Lindenhurst, NY 11757-2598
Phone (516) 743-9450
Other practice location 2
8812 Queens Blvd Ste 6
Elmhurst, NY 11373-4420
Phone (516) 743-9450
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03918421 | Medicaid | NY |
Other names 1
- Grewal Orthopedic and Spine Care
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | AdvancedMD | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190820000257 | NY | Part B Supplier - Clinic/Group Practice | 6800124512 |
Receives reassigned benefits from 11 practitioners Practice locations: East Meadow, NY |
| O20200219001189 | NY | DME Supplier - Physician - General Practice | 6800124512 | Practice locations: East Meadow, NY |
National Provider Directory
National Provider DirectoryLocations
30 Merrick Ave
Ste 103
East Meadow, NY 11554
Phone (516) 743-9450
150 Sunrise Hwy
Ste LL22
Lindenhurst, NY 11757
Phone (516) 743-9450
Practitioners & affiliated clinicians
Practitioners 12
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopaedic Surgery of the Spine Physician
- East Meadow, NY
- NPI 1144497033
NY, Orthopaedic Surgery
-
- Orthopaedic Surgery Physician
- Valley Stream, NY
- NPI 1699932186
NY, Orthopaedic Surgery
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Bronx, NY
- NPI 1508307737
Foot and Ankle Surgery, NY
-
- Orthopaedic Surgery of the Spine Physician
- Rochester, NY
- NPI 1083069603
NY, Orthopaedic Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560988800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1576540800000",
"number": "1780244798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 MERRICK AVE STE 103",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "115541580",
"telephone_number": "516-743-9450",
"fax_number": "516-743-9451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 MERRICK AVE STE 103",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "115541580",
"telephone_number": "516-743-9450",
"fax_number": "516-743-9451"
}
],
"practiceLocations": [
{
"address_1": "150 Sunrise Hwy Ste Ll-22",
"address_purpose": "LOCATION",
"city": "Lindenhurst",
"state": "NY",
"postal_code": "117572598",
"country_code": "US",
"telephone_number": "516-743-9450",
"fax_number": "516-743-9451",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8812 Queens Blvd Ste 6",
"address_purpose": "LOCATION",
"city": "Elmhurst",
"state": "NY",
"postal_code": "113734420",
"country_code": "US",
"telephone_number": "516-743-9450",
"fax_number": "516-743-9451",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "KANWARPAUL S. GREWAL MEDICAL PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-06-20",
"last_updated": "2019-12-17",
"certification_date": "2019-12-17",
"status": "A",
"authorized_official_last_name": "GREWAL",
"authorized_official_first_name": "KANWARPAUL",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "516-743-9450",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "207XS0117X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207XX0004X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207XX0801X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Orthopaedic Trauma",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03918421",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "AdvancedMD",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "30 Merrick Ave Ste 103",
"city": "East Meadow",
"state": "NY",
"country_code": "US",
"postal_code": "115541580",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Grewal Orthopedic and Spine Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in East Meadow, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.