Individual provider Active NPI

Mark Geoffery Grossman, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Garden City, NY
National Provider Identifier
1063402014
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
224563 Issued in NY
Practice address
1300 Franklin Ave
Suite Ul3A
Garden City, NY 11530-1886
Phone
(516) 747-8900
Fax
(516) 663-8124
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 224563 NY
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 224563 NY Primary

Addresses

Primary practice location

1300 Franklin Ave
Suite Ul3A
Garden City, NY 11530-1886

Mailing address

1300 Franklin Ave
Suite Ul3A
Garden City, NY 11530-1886
Phone (516) 747-8900

Other identifiers 1

IdentifierTypeStateIssuer
02359162MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgrossman238831@nyumc.direct-ci.com

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040415001354 NY Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 7416942834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

1300 Franklin Ave
Suite Ul3A
Garden City, NY 11530-1885
Phone (516) 747-8900

1530 Front St
East Meadow, NY 11554-2265
Phone (516) 324-7500

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224563NYMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University Orthopaedic Surgery CurrentSince Oct 1, 2018 Accepting new patients
Medical Group of Mineola, PC Past Accepting new patients

Locations

1530 Front St
East Meadow, NY 11554
Phone (516) 324-7500

2339 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 520-3053

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

1300 Franklin Ave
Ste UL3AB
Garden City, NY 11530

1300 Franklin Ave
Ste UL3A
Garden City, NY 11530
Phone (516) 663-3015

1300 Franklin Ave
Ste Ul
Garden City, NY 11530
Phone (516) 663-2224

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

120 Mineola Blvd
Ste 320
Mineola, NY 11501
Phone (516) 663-3300

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

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 7

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1063402014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE",
            "address_2": "SUITE UL3A",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301886",
            "telephone_number": "516-747-8900",
            "fax_number": "516-663-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE",
            "address_2": "SUITE UL3A",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301886",
            "telephone_number": "516-747-8900",
            "fax_number": "516-663-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "MARK",
        "middle_name": "GEOFFERY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "224563",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "224563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02359162",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgrossman238831@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "1300 Franklin Ave",
            "address_2": "SUITE UL3A",
            "city": "Garden City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115301886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.