Jack Grossman, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

801 Ostrum St
Bethlehem
Philadelphia, PA 18015

Phone

(484) 526-4000

Fax

(866) 691-7505

NPI assigned

May 2, 2022

Last updated

Jul 3, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1255076410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-4000",
            "fax_number": "866-691-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "address_2": "BETHLEHEM",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "18015",
            "telephone_number": "484-526-4000",
            "fax_number": "866-691-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "JACK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-02",
        "last_updated": "2023-07-03",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "OT022084",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Grossman, LSW
• Brooke Grossman, RDN, LDN
• Fern Marla Grossman, D.C.
• Gilbert Grossman, MD
• Hannah Grossman
• Lawrence B Grossman, MD
• Nicole Grossman
• Peter Grossman, M.D.
• Shoshana Grossman, M.D.
• Liron Grossmann

• Student in an Organized Health Care Education/Training Program in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Student in an Organized Health Care Education/Training Program in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.