NPIMap

Organization Active NPI

Jeffrey Mark Grossman M.D., P.a.

  • Internal Medicine Physician
  • Vero Beach, FL
National Provider Identifier
1205128667
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME64361 Issued in FL
Legal business name
JEFFREY MARK GROSSMAN M.D., P.A.
Practice address
920 37TH PL Ste 103
Vero Beach, FL 32960-6595
Phone
(772) 299-4046
Fax
(772) 299-0419
NPI assigned
May 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Authorized official

Name
Dr. Jeffrey Mark Grossman, MDNPI 1639159288
Title
President
Phone
(772) 299-4046

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME64361 FL Primary

Addresses

Primary practice location

920 37TH PL Ste 103
Vero Beach, FL 32960-6595

Mailing address

920 37TH PL Ste 103
Vero Beach, FL 32960-6595
Phone (772) 299-4046

Other identifiers 2

IdentifierTypeStateIssuer
23048OtherBCBS
1639159288OtherINDIVIDUAL NPI

National Provider Directory

National Provider Directory

Locations

920 37th Pl
Ste 103
Vero Beach, FL 32960
Phone (772) 299-4046

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304467200000",
    "number": "1205128667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 37TH PL STE 103",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606595",
            "telephone_number": "772-299-4046",
            "fax_number": "772-299-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 37TH PL STE 103",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606595",
            "telephone_number": "772-299-4046",
            "fax_number": "772-299-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY MARK GROSSMAN M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-299-4046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME64361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "23048",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1639159288",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; 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.