Jay R. Grossman, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G27789 Issued in CA

Practice address

3629 Vista Way
Oceanside, CA 92056-4522

Phone

(760) 828-9200

Fax

(760) 828-9141

NPI assigned

Jun 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Dermatology Specialists Inc

  • Dermatology Physician
  • San Marcos, CA
  • NPI 1578763876
  NPD (past)
• Dermatology Specialists Inc

  • Dermatology Physician
  • Oceanside, CA
  • NPI 1881631711
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1275574253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3629 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564522",
            "telephone_number": "760-828-9200",
            "fax_number": "760-828-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3629 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564522",
            "telephone_number": "760-828-9200",
            "fax_number": "760-828-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "JAY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G27789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070003595",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Gritzen
• Liana Groel, M.S., A.T.C.
• Daniel J Gross, PT
• Dustin Grossheim
• Marco Fulvio Grossi, PT, DPT
• James Norman Groth, MD
• Kieran Grow
• Brenda L Guadalupe, LMFT
• Karly Grace Gudykunst, OTR
• Michael Guerena, MD

• Dermatology Physician in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.