DR. EUGENE GRUDNIKOFF M.D.
NPI 1548553217
Psychiatry & Neurology - Child & Adolescent Psychiatry in Amityville, NY

Q: What is Eugene Grudnikoff's NPI number?

The NPI number for Eugene Grudnikoff is 1548553217. It was assigned to this individual provider in the NPPES registry on May 27, 2011.

Q: What is Eugene Grudnikoff's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Eugene Grudnikoff was last updated on August 20, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since May 27, 2011PECOS EnrolledAccepts Medicare Assignment

400 SUNRISE HWY, SOUTH OAKS HOSPITAL - CH203, AMITYVILLE, NY 11701(631) 608-5205(631) 608-4112 Get Directions Write a Review

NPPES record last updated: August 20, 2014. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Dr. Eugene Grudnikoff M.d. NPPES

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

DR. EUGENE GRUDNIKOFF M.D. (NPI 1548553217) is an individual child & adolescent psychiatry provider in Amityville, New York, licensed in New York (262638) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1548553217

Entity TypeIndividualMale

Primary Taxonomy2084P0804X

Provider Legal NameDR. EUGENE GRUDNIKOFFCredential: M.D.

Location Address400 SUNRISE HWY, SOUTH OAKS HOSPITAL - CH203Amityville, NY 11701-2508

Mailing Address400 Sunrise Hwy, South Oaks Hospital - Ch203Amityville, NY 11701-2508 · (631) 608-5205 · Fax (631) 608-4112

Phone(631) 608-5205

Fax(631) 608-4112

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateMay 27, 2011

Last NPPES UpdateAugust 20, 2014

✔ NPI 1548553217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

License✔ Licensed in NY · 262638

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

400 SUNRISE HWY, Amityville, NY 11701

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Eugene Grudnikoff M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466771845

PECOS Enrollment IDI20150506002045

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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VICTORIA LYN SPAHN

Counselor (Professional)