Individual provider Active NPI

Marc Robert Grossman, O.D.

  • Optometrist
  • New Paltz, NY
National Provider Identifier
1003904988
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3873 Issued in NY
Practice address
3 Paradies LN
New Paltz, NY 12561-4017
Phone
(845) 255-3728
Fax
(845) 255-0036
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3873 NY Primary
Vision Therapy Optometrist 152WV0400X 3873 NY

Addresses

Primary practice location

3 Paradies LN
New Paltz, NY 12561-4017

Mailing address

3 Paradies LN
New Paltz, NY 12561-4017
Phone (845) 255-3728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120203000400 NY Practitioner - Optometry 4082871959 Practice locations: New Paltz, NY; Somers, NY; Rye, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20 Chestnut St
Rye, NY 10580-2851
Phone (914) 967-1740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003873NYMDMental Health Counselor
3873NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Integral Chiropractic, P.C. PastSince Nov 16, 2013 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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1003904988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PARADIES LN",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125614017",
            "telephone_number": "845-255-3728",
            "fax_number": "845-255-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PARADIES LN",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125614017",
            "telephone_number": "845-255-3728",
            "fax_number": "845-255-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "MARC",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "3873",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NY",
            "license": "3873",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

Verify at the official NPI Registry.