Individual provider Active NPI

Lana Grzybicki, DPM

  • Podiatrist
  • Old Forge, PA
National Provider Identifier
1790737765
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC003236L Issued in PA
Practice address
429 S Main St
Ste 2
Old Forge, PA 18518-1684
Phone
(570) 457-1733
Fax
(570) 457-1734
NPI assigned
May 17, 2006
Last updated
Oct 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC003236L PA Primary

Addresses

Primary practice location

429 S Main St
Ste 2
Old Forge, PA 18518-1684

Mailing address

429 S Main St
Ste 2
Old Forge, PA 18518-1684
Phone (570) 457-1733

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080607000015 PA Practitioner - Podiatry 4284704982 Practice locations: Old Forge, PA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

429 S Main St
Suite 2
Old Forge, PA 18518-1684
Phone (270) 457-1733

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.64 of 100Reported as individual
Quality
67.82
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue27
Removal of nail tissue2136
Removal or shaving of skin growth1073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC003236LPAMDPodiatrist

Interoperability endpoints

  • Direct secure messaging: drgrzybicki@podiatrypractice.medentdirect.com

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1790737765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 S MAIN ST",
            "address_2": "STE 2",
            "city": "OLD FORGE",
            "state": "PA",
            "postal_code": "185181684",
            "telephone_number": "570-457-1733",
            "fax_number": "570-457-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 S MAIN ST",
            "address_2": "STE 2",
            "city": "OLD FORGE",
            "state": "PA",
            "postal_code": "185181684",
            "telephone_number": "570-457-1733",
            "fax_number": "570-457-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZYBICKI",
        "first_name": "LANA",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC003236L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Forge, PA

Sources for this page

Verify at the official NPI Registry.