Michael Grossman
Individual provider Active NPI Internal Medicine Physician · Valley, AL
NPI 1245239102 · NPPES record last updated Mar 22, 2022
Key facts
- NPI
- 1245239102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD.7925 (AL)
- Practice address
- 4505 20TH Ave
Valley, AL 36854-3542 - Phone
- (334) 756-9604
- Fax
- (334) 756-9606
- NPI assigned
- Jul 21, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 1972
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Heart Center Cardiology, PC
Practice addresses (Care Compare)
2375 Champions Blvd
Auburn, AL 36830-6471
Phone (334) 321-3700
Hospital & facility affiliations
- The East Alabama Healthcare Authority
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.26 of 100
- Quality
- 77.12
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.87
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040708000661 | AL | Practitioner - Emergency Medicine |
3173501095 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7925 | AL | MD | Pharmacist |
| 00007925 | AL | MD | Emergency Medicine Physician |
| MD.7925 | AL | MD | Internal Medicine Physician |
Practice roles (1 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medical Specialist | Past | Accepting new patients |
Networks
- bcbs alabama network 01H0
- bcbs alabama network 01A0
- bcbs alabama network 01C0
- bcbs alabama network 01E0
- bcbs alabama network 01B0
- bcbs alabama network 01G0
Interoperability endpoints
- michael.grossman.1@4384.direct.athenahealth.com
- michaelgrossman@vamp.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 00007925 | AL | |
| Internal Medicine Physician | 207R00000X | MD.7925 | AL | Yes |
Addresses
Primary practice location
4505 20TH Ave
Valley, AL 36854-3542
Mailing address
PO Box 315
Valley, AL 36854-0315
Phone (334) 756-9604
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000181145E | Medicaid | GA | |
| 009929055 | Medicaid | AL | |
| 51516975 | Other | AL | BC/BS ALABAMA |
Other providers in Valley, AL
- FDC, Inc
- Heather Laconya Veal Fields
- Mitchel Lewis Galishoff
- Rutilio Garcia
- Wendy Leigh Gray
- Alex Jay Hadaway
- Robert Hammond
- Gloria Brinson Harris
- James David Harris
- Malia Harvey
All providers in Valley, AL · Internal Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.