Individual provider Active NPI

Dana Grossmann, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Sterling Heights, MI
National Provider Identifier
1295404234
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704356960 Issued in MI
Practice address
6555 15 Mile Rd
Sterling Heights, MI 48312-4511
Phone
(855) 996-2264
NPI assigned
Sep 13, 2021
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704356960 MI Primary
Registered Nurse 163W00000X 4704356960 MI

Addresses

Primary practice location

6555 15 Mile Rd
Sterling Heights, MI 48312-4511

Mailing address

6555 15 Mile Rd
Sterling Heights, MI 48312-4511
Phone (855) 996-2264

Other practice location 1

6309 Mack Ave
Detroit, MI 48207-2302
Phone (313) 331-3435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250401000645 MI Practitioner - Nurse Practitioner 3375066392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wayne State University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Modern Psych and Wellness PLLCGroup PAC ID 8729529623, 7 clinicians

Practice addresses (Care Compare)

21415 Goddard Rd
Taylor, MI 48180-4247
Phone (248) 667-8014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704356960MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Psych and Wellness PLLC CurrentSince Jan 18, 2025 Accepting new patients
Back on Track Medical Equipment LLC CurrentSince Jan 18, 2025 Accepting new patients
Pure Honey Group LLC Past Accepting new patients

Locations

21415 Goddard Rd
Taylor, MI 48180
Phone (248) 667-8014

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.

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1295404234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483124511",
            "telephone_number": "855-996-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483124511",
            "telephone_number": "855-996-2264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6309 Mack Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482072302",
            "country_code": "US",
            "telephone_number": "313-331-3435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSSMANN",
        "first_name": "DANA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704356960",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704356960",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.