Organization Active NPI

Scott Grossman OD PA

  • Optometrist
  • North Miami Beach, FL
National Provider Identifier
1003930868
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4188 Issued in FL
Legal business name
SCOTT GROSSMAN OD PA
Practice address
18557 West Dixie Highway
North Miami Beach, FL 33180
Phone
(305) 466-0777
Fax
(305) 466-0773
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
Scott Grossman, OD PANPI 1750484564
Title
Optometrist
Phone
(305) 466-0777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC4188 FL Primary

Addresses

Primary practice location

18557 West Dixie Highway
North Miami Beach, FL 33180

Mailing address

18557 W Dixie Hwy
Miami, FL 33180-2614
Phone (305) 466-0777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081103000416 FL Part B Supplier - Clinic/Group Practice 0547329740 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

18557 W Dixie Hwy
Ste A
Miami, FL 33180
Phone (305) 466-0777

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1003930868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18557 W DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331802614",
            "telephone_number": "305-466-0777",
            "fax_number": "305-466-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18557 WEST DIXIE HIGHWAY",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "305-466-0777",
            "fax_number": "305-466-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT GROSSMAN OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "305-466-0777",
        "authorized_official_credential": "OD PA"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.