Active NPI
Stephen A Grant, M.D.
- Family Medicine Physician
- Clifton Park, NY
National Provider Identifier
1992711683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 136171
- Practice address
- 989 Route 146
BLDG.200
Clifton Park, NY 12065-3646 - Phone
- (518) 383-0891
- Fax
- (518) 383-1662
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 136171 | NY | Primary |
Addresses
Primary practice location
989 Route 146
BLDG.200
Clifton Park, NY 12065-3646
Mailing address
711 Troy Schenectady Rd Ste 203
Latham, NY 12110-2461
Phone (518) 782-3700
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000401094001 | Other | NY | BSNENY |
| 10000802 | Other | NY | CDPHP |
| 00884226 | Medicaid | NY | |
| 08116 | Other | NY | MVP |
| 47336 | Other | NY | GHI/HMO |
| 071009000031 | Other | NY | FIDELIS |
| 200225 | Other | NY | SENIOR WHOLE HEALTH |
| 7451113 | Other | NY | AETNA |
| 01V511 | Other | NY | EMPIRE BC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Physicians, PLLC | Family Medicine | 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.
-
- Family Medicine Physician
- Ballston Spa, NY
- NPI 1548541246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516233600000",
"number": "1992711683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 TROY SCHENECTADY RD STE 203",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102461",
"telephone_number": "518-782-3700",
"fax_number": "518-782-3799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "989 ROUTE 146",
"address_2": "BLDG.200",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120653646",
"telephone_number": "518-383-0891",
"fax_number": "518-383-1662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "STEPHEN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2018-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "136171",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSNENY",
"identifier": "000401094001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10000802",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00884226",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "08116",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI/HMO",
"identifier": "47336",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "071009000031",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENIOR WHOLE HEALTH",
"identifier": "200225",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7451113",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC",
"identifier": "01V511",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Clifton Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.