Organization Active NPI

Little Silver Dermatology LLC

  • Dermatology Physician
  • Little Silver, NJ
National Provider Identifier
1245814540
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
LITTLE SILVER DERMATOLOGY LLC
Practice address
680 Branch Ave
Little Silver, NJ 07739-1254
Phone
(732) 842-5222
Fax
(732) 741-6285
NPI assigned
May 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Authorized official

Name
Dr. Kenneth Grossman, MDNPI 1427012533
Title
Owner
Phone
(732) 842-5222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

680 Branch Ave
Little Silver, NJ 07739-1254

Mailing address

680 Branch Ave
Little Silver, NJ 07739-1254
Phone (732) 842-5222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210520000068 NJ Part B Supplier - Clinic/Group Practice 4284033473 Receives reassigned benefits from 3 practitioners
Practice locations: Little Silver, NJ

National Provider Directory

National Provider Directory

Locations

680 Branch Ave
Little Silver, NJ 07739
Phone (732) 842-5222

180 White Rd
Ste 103
Little Silver, NJ 07739
Phone (732) 575-1100

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1245814540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 BRANCH AVE",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391254",
            "telephone_number": "732-842-5222",
            "fax_number": "732-741-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BRANCH AVE",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391254",
            "telephone_number": "732-842-5222",
            "fax_number": "732-741-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE SILVER DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-12",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-842-5222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Silver, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.