Active NPI
Gilbert Grossman, MD
- Cardiovascular Disease Physician
- Philadelphia, PA
National Provider Identifier
1124092739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MD026156L
- Practice address
- 700 Cottman Ave
BLDG B, Suite 101
Philadelphia, PA 19111 - Phone
- (215) 745-4100
- Fax
- (215) 745-9565
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | MD026156L | PA | Primary |
Addresses
Primary practice location
700 Cottman Ave
BLDG B, Suite 101
Philadelphia, PA 19111
Mailing address
207 N Broad St
3Rd FLR.
Philadelphia, PA 19107-1500
Phone (267) 479-4142
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000741351 0018 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091231000355 | PA | Practitioner - Cardiovascular Disease (Cardiology) | 9537200316 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526515200000",
"number": "1124092739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 N BROAD ST",
"address_2": "3RD FLR.",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191071500",
"telephone_number": "267-479-4142",
"fax_number": "215-463-3820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 COTTMAN AVE",
"address_2": "BLDG B, SUITE 101",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19111",
"telephone_number": "215-745-4100",
"fax_number": "215-745-9565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSMAN",
"first_name": "GILBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2018-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "PA",
"license": "MD026156L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000741351 0018",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.