NPIMap

Organization Active NPI

Kanwarpaul S. Grewal Medical PLLC

Doing business as Grewal Orthopedic and Spine Care

  • Orthopaedic Surgery of the Spine Physician
  • East Meadow, NY
National Provider Identifier
1780244798
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
KANWARPAUL S. GREWAL MEDICAL PLLC
Doing business as
Grewal Orthopedic and Spine Care
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
Last updated
Dec 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Authorized official

Name
Dr. Kanwarpaul S Grewal, DONPI 1144497033
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)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X Primary
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X
Orthopaedic Trauma PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 names 1

  • Grewal Orthopedic and Spine Care Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL AdvancedMD Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Locations

8812 Queens Blvd
Ste 6
Elmhurst, NY 11373
Phone (347) 399-4369

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, 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": "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": [],
    "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.

Verify at the official NPI Registry.