Individual provider Active NPI

Svetlana Grosman, D.O.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1346221678
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
219277 Issued in NY
Practice address
618 Avenue H Ste C1
Brooklyn, NY 11230-2294
Phone
(718) 253-9110
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 219277 NY Primary

Addresses

Primary practice location

618 Avenue H Ste C1
Brooklyn, NY 11230-2294

Mailing address

618 Avenue H Ste C1
Brooklyn, NY 11230-2294
Phone (718) 253-9110

Other identifiers 2

IdentifierTypeStateIssuer
WHA171OtherNYMEDICARE GROUP NUMBER
02187864MedicaidNY

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
I20041023000108 NY Practitioner - Internal MedicinePractitioner - Family Practice 3274594130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

618 Ave H
Suite C1
Brooklyn, NY 11230-2294
Phone (718) 253-9110

Hospital & facility affiliations

  • Girling Health Care of New York Home health agency, Brooklyn, NY, CCN 337243
  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Family Medical Care PC Family Medicine CurrentSince Jul 1, 2002 Accepting new patients
Benson Medical Imaging PLLC Past Accepting new patients
Digestive Disease Medical Care of Ny,P.C. Past Accepting new patients
Bay Park One Medical, PC Family Medicine PastSince Aug 1, 2005 Accepting new patients
Park Slope Medical Service PC Past Accepting new patients

Locations

1214 Coney Island Ave
Brooklyn, NY 11230
Phone (718) 253-9110

Networks

  • Healthfirst Medicare Network H3359
  • 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.

Hospital & facility affiliations 2

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1346221678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 AVENUE H STE C1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112302294",
            "telephone_number": "718-253-9110",
            "fax_number": "718-253-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 AVENUE H STE C1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112302294",
            "telephone_number": "718-253-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSMAN",
        "first_name": "SVETLANA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "219277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "WHA171",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02187864",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.