Individual provider Active NPI

Faustyna Grzybowska, FNP

  • Family Nurse Practitioner
  • Glendale, NY
National Provider Identifier
1811760051
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
353049 Issued in NY
Practice address
6506 Myrtle Ave
Glendale, NY 11385-6250
Phone
(929) 293-4256
Fax
(718) 367-2555
NPI assigned
Oct 31, 2023
Last updated
Feb 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 353049 NY Primary

Addresses

Primary practice location

6506 Myrtle Ave
Glendale, NY 11385-6250

Mailing address

6506 Myrtle Ave
Glendale, NY 11385-6250
Phone (929) 293-4256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240822002810 NY Practitioner - Nurse Practitioner 8628517695 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
353049NYMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Doral Medical and Multi Specialty Facility LLC CurrentSince Apr 1, 2025 Accepting new patients
Medical Sinai Healthcare PC. CurrentSince Jun 16, 2024 Accepting new patients
Doral Pharmacy LLC PastSince Apr 1, 2025 Accepting new patients

Locations

1797 Pitkin Ave
Brooklyn, NY 11212
Phone (718) 367-2555

1797 Pitkin Ave
Ste 2
Brooklyn, NY 11212
Phone (718) 367-2555

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

6506 Myrtle Ave
Glendale, NY 11385
Phone (516) 423-6141

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAIGDD/Endpoint/EAIGDD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1811760051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6506 MYRTLE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113856250",
            "telephone_number": "929-293-4256",
            "fax_number": "718-367-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6506 MYRTLE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113856250",
            "telephone_number": "929-293-4256",
            "fax_number": "718-367-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZYBOWSKA",
        "first_name": "FAUSTYNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-31",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "353049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

Verify at the official NPI Registry.