Kenneth R Grossman MD Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

KENNETH R GROSSMAN MD INC

Practice address

580 Collins Dr
Merced, CA 95348-3121

Phone

(209) 383-0989

NPI assigned

Jul 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Randell Grossman, MDNPI 1184684672

Title

Owner Physician

Phone

(209) 383-0989

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Randell Grossman, M.D.

  • Ophthalmology Physician
  • Merced, CA
  • NPI 1184684672
  Medicare reassignment Care Compare group NPD Authorized official
• Dennis Whittier Hartman, O.D.

  • Optometrist
  • Merced, CA
  • NPI 1922078294
  Medicare reassignment Care Compare group NPD
• Omran Nattouf, PA

  • Physician Assistant
  • Merced, CA
  • NPI 1609685627
  NPD

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174537021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 COLLINS DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953483121",
            "telephone_number": "209-383-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 COLLINS DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953483121",
            "telephone_number": "209-383-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH R GROSSMAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "RANDELL",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "209-383-0989",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0087430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joash Kipkurui Kemei
• Ken Chan DDS Inc
• Adilene Jennifer Kendall
• Kenichi T. Miyata MD Inc
• Kelsey Kennedy
• Kevin Tran Merced Wellness Chiropractic Professional Corporation (Merced Wellness)
• Christina Michelle Keys Gonzalez
• Aisha Khader, MD
• Charleyne Khamasi-Soomalan
• Abrar Jahin Khan, DMD

• Ophthalmology Physician in Merced, CA
• Providers in Merced, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.