Individual provider Active NPI

Melissia Elisa Grosjean, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1063958817
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA058827 Issued in PA
Practice address
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone
(215) 456-7890
NPI assigned
Jan 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA058827 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Philadelphia, PA 19141-3018

Mailing address

3502 Scotts LN Ste 2132
Philadelphia, PA 19129-1569
Phone (267) 597-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200128002360 PA Practitioner - Physician Assistant 4183984891 Reassigns benefits to 5 organizations
I20260210003236 CT Practitioner - Physician Assistant 4183984891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Connecticut LLCGroup PAC ID 8628104072, 36 clinicians

Practice addresses (Care Compare)

31 Union St
Vernon, CT 06066-3126
Phone (860) 872-0501

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Connecticut, LLC CurrentSince Dec 5, 2025 Accepting new patients
The Milton S Hershey Medical Center Physicians Group CurrentSince Jan 6, 2020 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Jan 6, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 24, 2022 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 24, 2022 Accepting new patients

Locations

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

Organizations & group practices 9

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": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1063958817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 SCOTTS LN STE 2132",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291569",
            "telephone_number": "267-597-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSJEAN",
        "first_name": "MELISSIA",
        "middle_name": "ELISA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.