Individual provider Active NPI

Molly Grassman, PA-C

  • Medical Physician Assistant
  • Fernandina Beach, FL
National Provider Identifier
1275807422
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9121709 Issued in FL
Practice address
1699 S 14TH St Ste 16
Fernandina Beach, FL 32034-1965
Phone
(904) 223-3321
Fax
(904) 223-2169
NPI assigned
Mar 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9121709 FL Primary

Addresses

Primary practice location

1699 S 14TH St Ste 16
Fernandina Beach, FL 32034-1965

Mailing address

5191 First Coast Tech Pkwy FL 3
Jacksonville, FL 32224-0609
Phone (904) 223-3321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20140827002864 AZ Practitioner - Physician Assistant 7719149178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

1315 S la Canada Dr
Green Valley, AZ 85622-1915
Phone (520) 420-2865

2380 N Ferguson Ave
Tucson, AZ 85712-2837

603 N Wilmot Rd
Suite 151
Tucson, AZ 85711-2701
Phone (520) 420-2560

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Oncology Associates PC CurrentSince Aug 1, 2016 Accepting new patients
Banner Urgent Care Services, LLC Past Accepting new patients
East Valley Urgent Care, LLC Past Accepting new patients

Locations

1315 S La Canada Dr
Green Valley, AZ 85622
Phone (520) 420-2480

1760 E River Rd
Ste 350
Tucson, AZ 85718
Phone (520) 519-7720

2625 N Craycroft Rd
Ste 20
Tucson, AZ 85712
Phone (520) 324-2409

603 N Wilmot Rd
Ste 151
Tucson, AZ 85711
Phone (520) 420-2560

1620 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 624-7445

Interoperability endpoints

  • Direct secure messaging: molly.grassman@aoa.ikm.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1275807422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY FL 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 S 14TH ST STE 16",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341965",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRASSMAN",
        "first_name": "MOLLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9121709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.