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DR. JACK GRUBER D.D.S.
NPI 1457424186
Dentist - Periodontics in Great Neck, NY

Active since November 17, 2006PECOS Enrolled
54 OLD POND RD, GREAT NECK, NY 11023(516) 466-3605 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jack Gruber D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK GRUBER D.D.S. (NPI 1457424186) is an individual periodontics provider in Great Neck, New York, licensed in New York (028946) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457424186
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. JACK GRUBERCredential: D.D.S.
Location Address54 OLD POND RDGreat Neck, NY 11023-1031
Mailing Address54 Old Pond RdGreat Neck, NY 11023-1031 · (516) 466-3605
Phone(516) 466-3605
Sole ProprietorYes
Enumeration DateNovember 17, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1457424186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in NY · 028946
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
54 OLD POND RD, Great Neck, NY 11023
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jack Gruber D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11023 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Gruber's NPI number?

The NPI number for Jack Gruber is 1457424186. It was assigned to this individual provider in the NPPES registry on November 17, 2006.

Where is Jack Gruber located?

Jack Gruber practices at 54 Old Pond Rd, Great Neck, NY 11023. The listed phone number is (516) 466-3605.

What is Jack Gruber's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Jack Gruber enrolled in Medicare?

Yes. Jack Gruber is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Gruber was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.