Individual provider Active NPI

Robert A Grossman, MD

  • Obstetrics Physician
  • Thousand Oaks, CA
National Provider Identifier
1053462606
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
G039997 Issued in CA
Practice address
558 Ventu Park Rd Ste a
Thousand Oaks, CA 91320-2752
Phone
(818) 817-9832
Fax
(818) 817-9835
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X G039997 CA Primary

Addresses

Primary practice location

558 Ventu Park Rd Ste a
Thousand Oaks, CA 91320-2752

Mailing address

558 Ventu Park Rd Ste a
Thousand Oaks, CA 91320-2752
Phone (818) 817-9832

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20090903000178 CA Practitioner - Obstetrics/Gynecology 3476453796 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Southern California Keck School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grossman and Grossman MDS a Medical CorporationGroup PAC ID 1850340209, 2 clinicians

Practice addresses (Care Compare)

558 N Ventu Park Rd
Suite a
Thousand Oaks, CA 91320-2752
Phone (805) 498-0240

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G039997CAMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grossman and Grossman M D S a Medical Corporation Obstetrics CurrentSince May 8, 1992 Accepting new patients
Obhg California, P.C. CurrentSince Apr 1, 2022 Accepting new patients
Los Robles Regional Medical Center Past Accepting new patients

Locations

558 N Ventu Park Rd
Ste A
Thousand Oaks, CA 91320
Phone (805) 498-0240

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJJGBA/Endpoint/EJJGBA

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1053462606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 VENTU PARK RD STE A",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913202752",
            "telephone_number": "818-817-9832",
            "fax_number": "818-817-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 VENTU PARK RD STE A",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913202752",
            "telephone_number": "818-817-9832",
            "fax_number": "818-817-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CA",
            "license": "G039997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.