Wendy Lynn Grossman, DPM

Primary specialty

Sports Medicine PodiatristTaxonomy code 213ES0000X

License

25MD00230300 Issued in NJ

Practice address

905 Broad St
Bloomfield, NJ 07003-2869

Phone

(973) 566-0811

Fax

(973) 566-0833

NPI assigned

Nov 28, 2006

Last updated

Sep 14, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: wgrossman188825@ahs.direct-ci.com

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1124194410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 BROAD ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032869",
            "telephone_number": "973-566-0811",
            "fax_number": "973-566-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 BROAD ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032869",
            "telephone_number": "973-566-0811",
            "fax_number": "973-566-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "WENDY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NJ",
            "license": "25MD00230300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6641601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Rose Graziano, NURSE PRACTITIONER
• Mera Greec, PT
• Tameka Green Foote, LPC
• Richard Greene, LCSW
• Ashley Greenfield, DPT
• Emilio Anthony Grugnale, D.C.
• Michael Guglielmino, LCSW
• Mary Guillermain
• Justin Gutman, M.D.
• Hackensack University Medical Cener

• Podiatrist in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.

Verify at the official NPI Registry.