Active NPI
Tonya Lea Gruttaria, PNP
- Pediatric Nurse Practitioner
- Orchard Park, NY
National Provider Identifier
1891896296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- F-381526
- Practice address
- 24 Carrow St
Orchard Park, NY 14127-2604 - Phone
- (716) 662-3443
- Fax
- (716) 972-0374
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | F-381526 | NY | Primary |
Addresses
Primary practice location
24 Carrow St
Orchard Park, NY 14127-2604
Mailing address
24 Carrow St
Orchard Park, NY 14127-2604
Phone (716) 662-3443
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000560738003 | Other | NY | BLUE CROSS/BLUE SHIELD (HEALTH NOW) |
| 02378572 | Medicaid | NY | |
| 00026923001 | Other | NY | UNIVERA HEALTHCARE |
| 9512148 | Other | NY | INDEPENDENT HEALTH ASSOCIATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F-381526 | NY | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carrow Street Pediatrics, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Adolescent Medicine Physician
- Orchard Park, NY
- NPI 1902098494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288828800000",
"number": "1891896296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 CARROW ST",
"city": "ORCHARD PARK",
"state": "NY",
"postal_code": "141272604",
"telephone_number": "716-662-3443",
"fax_number": "716-972-0374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 CARROW ST",
"city": "ORCHARD PARK",
"state": "NY",
"postal_code": "141272604",
"telephone_number": "716-662-3443",
"fax_number": "716-972-0374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUTTARIA",
"first_name": "TONYA",
"middle_name": "LEA",
"name_prefix": "Mrs.",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2010-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "F-381526",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD (HEALTH NOW)",
"identifier": "000560738003",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02378572",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA HEALTHCARE",
"identifier": "00026923001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT HEALTH ASSOCIATION",
"identifier": "9512148",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orchard Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.