NPIMap

Organization Active NPI

Grossman & Grossman, LTD.

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1245679620
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GROSSMAN & GROSSMAN, LTD.
Practice address
1300 N 12TH St Ste 550
Phoenix, AZ 85006-2820
Phone
(602) 468-2077
Fax
(480) 609-9552
NPI assigned
Jun 19, 2013
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Mr. Jon Birdell Grossman, MSW MEDNPI 1164575486
Title
President/Executive Director
Phone
(602) 410-6637

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH4275 AZ
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1300 N 12TH St Ste 550
Phoenix, AZ 85006-2820

Mailing address

PO Box 14948
Scottsdale, AZ 85267
Phone (602) 410-6635

Other identifiers 1

IdentifierTypeStateIssuer
825703MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120705000176 AZ Part B Supplier - Clinic/Group Practice 3476718057 Receives reassigned benefits from 2 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Grossman Grossman LTD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

123 N Florence St
Casa Grande, AZ 85122

125 N Florence St
Casa Grande, AZ 85122

1136 E Harmony Ave
Ste AND205
Mesa, AZ 85204

9460 W Peoria Ave
Ste F
Peoria, AZ 85345
Phone (623) 878-8888

1300 N 12th St
Ste 550
Phoenix, AZ 85006
Phone (602) 254-5229

2345 E Thomas Rd
Ste 360
Phoenix, AZ 85016
Phone (602) 410-6635

1701 W Saint Marys Rd
Ste 124
Tucson, AZ 85745
Phone (602) 438-2077

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1245679620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14948",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85267",
            "telephone_number": "602-410-6635",
            "fax_number": "480-609-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062820",
            "telephone_number": "602-468-2077",
            "fax_number": "480-609-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROSSMAN & GROSSMAN, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-19",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "BIRDELL",
        "authorized_official_title_or_position": "PRESIDENT/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "602-410-6637",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW MED"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH4275",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "825703",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.