Individual provider Active NPI

Michael Grossman

  • Internal Medicine Physician
  • Valley, AL
National Provider Identifier
1245239102
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.7925 Issued in AL
Practice address
4505 20TH Ave
Valley, AL 36854-3542
Phone
(334) 756-9604
Fax
(334) 756-9606
NPI assigned
Jul 21, 2005
Last updated
Mar 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00007925 AL
Internal Medicine Physician 207R00000X MD.7925 AL Primary

Addresses

Primary practice location

4505 20TH Ave
Valley, AL 36854-3542

Mailing address

PO Box 315
Valley, AL 36854-0315
Phone (334) 756-9604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040708000661 AL Practitioner - Emergency MedicinePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 3173501095 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Heart Center Cardiology, PCGroup PAC ID 5092768341, 7 clinicians

Practice addresses (Care Compare)

2375 Champions Blvd
Auburn, AL 36830-6471
Phone (334) 321-3700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.26 of 100Reported as group
Quality
77.12
Promoting interoperability
100
Improvement activities
40
Cost
76.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7925ALMDPharmacist
00007925ALMDEmergency Medicine Physician
MD.7925ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Specialist Past Accepting new patients

Networks

  • bcbs alabama network 01H0
  • bcbs alabama network 01C0
  • bcbs alabama network 01E0
  • bcbs alabama network 01A0
  • bcbs alabama network 01B0
  • bcbs alabama network 01G0

Interoperability endpoints

  • Direct secure messaging: michael.grossman.1@4384.direct.athenahealth.com
  • Direct secure messaging: michaelgrossman@vamp.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1245239102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 315",
            "city": "VALLEY",
            "state": "AL",
            "postal_code": "368540315",
            "telephone_number": "334-756-9604",
            "fax_number": "334-756-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 20TH AVE",
            "city": "VALLEY",
            "state": "AL",
            "postal_code": "368543542",
            "telephone_number": "334-756-9604",
            "fax_number": "334-756-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "00007925",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD.7925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley, AL

Sources for this page

Verify at the official NPI Registry.