Individual provider Active NPI

Mitchell Stuart Grobman, MD

  • Neurology Physician
  • Neptune, NJ
National Provider Identifier
1073556056
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA12088100 Issued in NJ
Practice address
1945 State Route 33
Neptune, NJ 07753-4859
Phone
(732) 897-3600
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036-084209 IL
Neurology Physician 2084N0400X 25MA12088100 NJ Primary

Addresses

Primary practice location

1945 State Route 33
Neptune, NJ 07753-4859

Mailing address

331 Newman Springs Rd
BLDG 2, Ste 220
Red Bank, NJ 07701-5688

Other practice location 1

1500 SW 10th Ave
Topeka, KS 66604-1301
Phone (785) 357-2554

Other practice location 2

1900 Hollister Dr
Suite 250
Libertyville, IL 60048-5233
Phone (847) 549-0055

Other identifiers 1

IdentifierTypeStateIssuer
036084209MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mgrobman95800@stormontvaildirect.org Direct COTTON O'NEIL CLINIC REVOCABLE TRUST
Direct Messaging Address mgrobman95800@stormontvaildirect.org Direct STORMONT-VAIL HEALTHCARE INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240504000334 NJ Practitioner - Neurology 2567623267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

1945 Route 33
Ackerman 4
Neptune, NJ 07753
Phone (732) 776-4949

Hospital & facility affiliations

  • Ocean Medical Center Hospital, Brick, NJ, CCN 310052
  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-084209ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Apr 1, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Apr 1, 2024 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1945 State Route 33
#4
Neptune, NJ 07753
Phone (732) 776-4949

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

Interoperability endpoints

  • Direct secure messaging: mgrobman95800@stormontvaildirect.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 2

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 5

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1073556056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD",
            "address_2": "BLDG 2, STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 STATE ROUTE 33",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534859",
            "telephone_number": "732-897-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 SW 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Topeka",
            "state": "KS",
            "postal_code": "666041301",
            "country_code": "US",
            "telephone_number": "785-357-2554",
            "fax_number": "785-354-0549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 Hollister Dr",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600485233",
            "country_code": "US",
            "telephone_number": "847-549-0055",
            "fax_number": "847-549-0404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROBMAN",
        "first_name": "MITCHELL",
        "middle_name": "STUART",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-084209",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA12088100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084209",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgrobman95800@stormontvaildirect.org",
            "affiliation": "Y",
            "endpointDescription": "SVH Secure messaging",
            "affiliationName": "COTTON O'NEIL CLINIC REVOCABLE TRUST",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1500 SW 10th Ave",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666041301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgrobman95800@stormontvaildirect.org",
            "affiliation": "Y",
            "endpointDescription": "SVH Secure messaging",
            "affiliationName": "STORMONT-VAIL HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1500 SW 10th Ave",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666041301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.