Traci Lynn Grossman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005369 Issued in MI

Practice address

2000 Green Rd
Ann Arbor, MI 48105-1598

Phone

(734) 995-2913

NPI assigned

Aug 12, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Emergency Medical Associates, PLLC

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1346227626

  Physician Assistant

  NPD (past)
• Vein Center at Allure Medical Spa, PLLC

  • Multi-Specialty Clinic/Center
  • Greenville, SC
  • NPI 1336636786
  NPD (past)

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1104072040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3602 ELMHURST AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480732332",
            "telephone_number": "989-415-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GREEN RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051598",
            "telephone_number": "734-995-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "TRACI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Zachary Gross, PHD
• Milton David Gross, MD
• Sophie Gross
• Tia Gross
• Paul Michael Grossman, MD
• Sophia Grossnickle, PT
• Kimberly Lynn Grosso, CRNA
• Jonathan Paul Groszek
• James Bernard Grotberg, MD
• Michael Joel Grotenrath, PA-C

• Physician Assistant in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.