Gary Prusky Grinberg, DO

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

92304 Issued in GA

Practice address

1446 Harper St
Augusta, GA 30912-0012

Phone

(706) 721-9442

NPI assigned

May 28, 2019

Last updated

Apr 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Gary Prusky Professional name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Emergency Coverage, LLC

  dba Emergency Coverage Corporation of TeamHealth

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  GA

  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  dba WellStar Urogynecology

  • Gynecology Physician
  • Austell, GA
  • NPI 1871939405
  NPD

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1891352746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 HART WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300394688",
            "telephone_number": "678-651-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 HARPER ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120012",
            "telephone_number": "706-721-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSKY GRINBERG",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "10974",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "GA",
            "license": "92304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GARY",
            "last_name": "PRUSKY",
            "prefix": "DR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Pruitthealth - Richmond, LLC
• Pruitthealth Dialysis Services, Inc.
• Pruitthealth Home First, Inc. (Pruitthealth Home First - Augusta)
• Pruitthealth Home Health, Inc. (PruittHealth @ Home - Augusta)
• Pruitthealth Hospice, Inc. (PruittHealth Hospice - Augusta)
• Psi, LLC (ElderCare Pharmacy)
• PT Solutions of Acworth LLC
• PT Solutions of Acworth LLC
• PT Solutions of Acworth LLC
• Publix Super Markets Inc (Publix Pharmacy #0525)

• Pediatric Emergency Medicine (Pediatrics) Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.