Individual provider Active NPI

Elky Grossman, PA

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1265880710
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007731 Issued in NY
Practice address
1840 52ND St Apt 9
Brooklyn, NY 11204-1606
Phone
(718) 331-9433
NPI assigned
May 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 007731 NY Primary

Addresses

Primary practice location

1840 52ND St Apt 9
Brooklyn, NY 11204-1606

Mailing address

1840 52ND St Apt 9
Brooklyn, NY 11204-1606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210722002394 NY Practitioner - Physician Assistant 7517360910 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parcare Community Health Network IncGroup PAC ID 4981823390, 99 clinicians

Practice addresses (Care Compare)

445 Park Ave
Brooklyn, NY 11205-2735
Phone (718) 963-0800

6010 Bay Pkwy
Suite 603
Brooklyn, NY 11204-6080
Phone (718) 236-7520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Parcare Community Health Network Inc CurrentSince May 1, 2024 Accepting new patients
Pharma Holding Inc PastSince Jul 23, 2023 Accepting new patients
Oda Primary Health Care Network, Inc. Past Accepting new patients

Locations

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1265880710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 52ND ST APT 9",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 52ND ST APT 9",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041606",
            "telephone_number": "718-331-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "ELKY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.