Tonya Grissam, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301106345 Issued in MI

Practice address

6451 N Federal Hwy Ste 800
Fort Lauderdale, FL 33308-1409

Phone

(800) 586-5022

Fax

(954) 229-9801

NPI assigned

Nov 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Tonya Monique Grissam Other name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tonya.grissam.1@22710.direct.athenahealth.com

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.

• Dickinson County Healthcare System

  • Emergency Medical Services (Emergency Medicine) Physician
  • Iron Mountain, MI
  • NPI 1891751186

  Pediatrics

  Medicare reassignment NPD
• Mymichigan Medical Center Alma

  • Emergency Medicine Physician
  • Alma, MI
  • NPI 1568914422
  Medicare reassignment NPD
• Mymichigan Medical Center Alpena

  • Emergency Medicine Physician
  • Alpena, MI
  • NPI 1508332792
  Medicare reassignment NPD
• Mymichigan Medical Center Gladwin

  • General Practice Physician
  • Gladwin, MI
  • NPI 1881869774
  Medicare reassignment NPD
• Dickinson County Healthcare System

  • Podiatrist
  • Iron Mountain, MI
  • NPI 1649578808
  NPD
• Mymichigan Medical Center Alma

  • Family Medicine Physician
  • Alma, MI
  • NPI 1265596126
  NPD
• Mymichigan Medical Center Alpena

  • Internal Medicine Physician
  • Alpena, MI
  • NPI 1942302302
  NPD
• Mymichigan Medical Center Gladwin

  • Medicare Defined Swing Bed Hospital Unit
  • Gladwin, MI
  • NPI 1588374813
  NPD
• Southern Monterey County Memorial Hospital

  • Critical Access Hospital
  • King City, CA
  • NPI 1114917564
  NPD
• Dickinson County Healthcare System

  • General Acute Care Hospital
  • Iron Mountain, MI
  • NPI 1801887013
  NPD (past)
• Mymichigan Medical Center Alma

  • General Acute Care Hospital
  • Alma, MI
  • NPI 1023097771
  NPD (past)
• Mymichigan Medical Center West Branch

  • General Acute Care Hospital
  • West Branch, MI
  • NPI 1538566765
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767225600000",
    "number": "1043385131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 N FEDERAL HWY STE 800",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081409",
            "telephone_number": "800-586-5022",
            "fax_number": "954-229-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 N FEDERAL HWY STE 800",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081409",
            "telephone_number": "800-586-5022",
            "fax_number": "954-229-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSAM",
        "first_name": "TONYA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2026-01-01",
        "certification_date": "2026-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301106345",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "051567",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000960913D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000960913I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000960913H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONYA",
            "last_name": "GRISSAM",
            "middle_name": "MONIQUE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nichole Grillo-Santiago
• Katelyn Grillo
• Kori L Grillo, LCSW
• Jade Elle Winstyn Grimes, BCBA
• Brenda Shubert Griner, ARNP
• Mischa Marie Grissomdarrisaw, MSW
• Linda A Groene, M.D
• Groeneveld Enterprises, Inc.
• Groenveld Enterprises Inc
• Irina Grosman, M.D.

• Pediatrics Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.