Individual provider Active NPI

Gary David Grossman, MD

  • Vascular & Interventional Radiology Physician
  • Poughkeepsie, NY
National Provider Identifier
1275507154
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
186503 Issued in NY
Practice address
241 North Rd
Poughkeepsie, NY 12601-1154
Phone
(845) 471-5519
Fax
(845) 471-2928
NPI assigned
Feb 15, 2006
Last updated
May 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 186503 NY
Vascular & Interventional Radiology Physician 2085R0204X 186503 NY Primary

Addresses

Primary practice location

241 North Rd
Poughkeepsie, NY 12601-1154

Mailing address

85 Civic Center PLZ
104
Poughkeepsie, NY 12601-2498
Phone (845) 471-5519

Other identifiers 1

IdentifierTypeStateIssuer
01646491MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040610000465 NY Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 8426030107 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
State University of New York Downstate Medical Center, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Diagnostic Imaging, PLLCGroup PAC ID 0547242224, 14 clinicians
Hudson Valley Diagnostic Imaging PLLCGroup PAC ID 6204729452, 16 clinicians
New Rochelle Radiology Associates PCGroup PAC ID 8921997479, 13 clinicians

Practice addresses (Care Compare)

14 Raymond Ave
Poughkeepsie, NY 12603-2312
Phone (845) 471-2848

175 Memorial Hwy
New Rochelle, NY 10801-5635
Phone (914) 633-7700

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
186503NYMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Diagnostic Imaging PLLC Current Accepting new patients
Capital Imaging Associates Diagnostic Radiology CurrentSince Aug 1, 2024 Accepting new patients
New Rochelle Radiology Associates, P.C. Diagnostic Radiology CurrentSince Aug 1, 2024 Accepting new patients
Hudson Valley Diagnostic Imaging, PLLC Diagnostic Radiology CurrentSince Aug 1, 2024 Accepting new patients
Medical Diagnostic Imaging PLLC CurrentSince Aug 5, 2002 Accepting new patients
Israel Schur MD PLLC Vascular & Interventional Radiology CurrentSince Feb 1, 2020 Accepting new patients
Mid- Hudson Medical Group P C Past Accepting new patients
Anesthesia Associates of St. Francis, P.C Past Accepting new patients

Locations

3 Emma Ln
Clifton Park, NY 12065
Phone (518) 278-4334

60 Merritt Blvd
Ste 107
Fishkill, NY 12524
Phone (845) 896-1900

175 Memorial Hwy
New Rochelle, NY 10801
Phone (914) 235-3535

575 Hudson Valley Ave
Ste 101
New Windsor, NY 12553
Phone (845) 220-2222

14 Raymond Ave
Poughkeepsie, NY 12603
Phone (845) 471-2848

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

1323 Route 9
Wappingers Falls, NY 12590
Phone (914) 297-9493

Networks

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

Organizations & group practices 10

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

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1275507154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 CIVIC CENTER PLZ",
            "address_2": "104",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126012498",
            "telephone_number": "845-471-5519",
            "fax_number": "845-471-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 NORTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011154",
            "telephone_number": "845-471-5519",
            "fax_number": "845-471-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "GARY",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "186503",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "186503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01646491",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.