Individual provider Active NPI

Abigail M Grossman, M.D.

  • Pediatrics Physician
  • Paramus, NJ
National Provider Identifier
1083894182
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA07066400 Issued in NJ
Practice address
22 Madison Ave
Paramus, NJ 07652-2734
Phone
(201) 291-9797
Fax
(201) 291-9798
NPI assigned
Nov 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA07066400 NJ Primary

Addresses

Primary practice location

22 Madison Ave
Paramus, NJ 07652-2734

Mailing address

815 Frederick CT
Wyckoff, NJ 07481-1088
Phone (201) 848-1375

Other practice location 1

177 Summit Ave
Hackensack, NJ 07601-1311
Phone (201) 487-8222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160419002737 NY Practitioner - Pediatric Medicine 8729386065 Reassigns benefits to 1 organization
I20240718003368 NJ Practitioner - Pediatric Medicine 8729386065 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07066400NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Jun 24, 2024 Accepting new patients
Summit Medical Group PA CurrentSince Jun 24, 2024 Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Mar 1, 2016 Accepting new patients
Boston Children'S Health Physicians, LLP Pediatrics CurrentSince Mar 1, 2016 Accepting new patients
Summit Medical Group, Inc Pediatrics Past Accepting new patients
Mona M Tantawi,MD,PC Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

337 N Main St
Ste 4
New City, NY 10956
Phone (845) 634-7900

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: abigail.grossman.1@2983.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1083894182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 FREDERICK CT",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811088",
            "telephone_number": "201-848-1375",
            "fax_number": "201-848-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MADISON AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522734",
            "telephone_number": "201-291-9797",
            "fax_number": "201-291-9798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 Summit Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011311",
            "country_code": "US",
            "telephone_number": "201-487-8222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "ABIGAIL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07066400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.