NPIMap

Individual provider Active NPI

Michael Anthony Grasso, MD

  • Nephrology Physician
  • West Orange, NJ
National Provider Identifier
1821063785
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA02860400 Issued in NJ
Practice address
111 Northfield Avenue
Suite 311
West Orange, NJ 07052-4703
Phone
(973) 325-2103
Fax
(973) 325-2254
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25MA02860400 NJ Primary

Addresses

Primary practice location

111 Northfield Avenue
Suite 311
West Orange, NJ 07052-4703

Mailing address

111 Northfield Avenue
Suite 311
West Orange, NJ 07052-4703
Phone (973) 325-2103

Other identifiers 1

IdentifierTypeStateIssuer
1207202MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100107000330 NJ Practitioner - NephrologyPractitioner - Internal Medicine 8022026939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Maryland School of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Nephrology Group PAGroup PAC ID 9133220825, 6 clinicians

Practice addresses (Care Compare)

111 Northfield Ave
Suite 311
West Orange, NJ 07052-4703
Phone (973) 325-2103

Hospital & facility affiliations

  • DaVita East Orange Dialysis Dialysis facility, East Orange, NJ, CCN 312522
  • DaVita Hillside Dialysis Dialysis facility, Hillside, NJ, CCN 312587
  • DaVita West Orange Dialysis Dialysis facility, West Orange, NJ, CCN 312636
  • FMC Maplewood Dialysis facility, Maplewood, NJ, CCN 312586
  • Alaris Health at Essex Dialysis facility, Irvington, NJ, CCN 312676
  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA02860400NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Hospital Opco LLC Current Accepting new patients
The Nephrology Group PA Nephrology CurrentSince Jun 15, 1989 Accepting new patients
Jersey City Artificial Kidney Center, LLC PastSince May 9, 1997 Accepting new patients
3 Dimension Diagnostic Solutions Past Accepting new patients
Newark Renal Centers, LLC PastSince Dec 16, 2003 Accepting new patients

Locations

111 Northfield Ave
Ste 311
West Orange, NJ 07052
Phone (201) 325-2103

Interoperability endpoints

  • Direct secure messaging: michael.grasso.1@9736.direct.athenahealth.com
  • Direct secure messaging: michael.grasso@direct.christhospital.md

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1821063785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NORTHFIELD AVENUE",
            "address_2": "SUITE 311",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524703",
            "telephone_number": "973-325-2103",
            "fax_number": "973-325-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NORTHFIELD AVENUE",
            "address_2": "SUITE 311",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524703",
            "telephone_number": "973-325-2103",
            "fax_number": "973-325-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRASSO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA02860400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1207202",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.