Active NPI
Brian Grossman
- Primary Care Nurse Practitioner
- Allen Park, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 4704306156
- Practice address
- 14575 Southfield Rd
Allen Park, MI 48101-2640 - Phone
- (313) 381-8787
- NPI assigned
- Apr 13, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Southfield, MI
- NPI 1962693960
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ear Nose and Throat Consultants PC
Practice addresses (Care Compare)
26850 Providence Pkwy
Suite 165
Novi, MI 48374-1255
Phone (248) 569-5985
27483 Dequindre Rd
Suite 201
Madison Heights, MI 48071-5711
Phone (248) 569-5985
29201 Telegraph Rd
Suite 500
Southfield, MI 48034-7648
Phone (248) 569-5985
Hospital & facility affiliations
- Beaumont Hospital - Grosse Pointe
- Beaumont Hospital Royal Oak
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
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180509001470 | MI | Practitioner - Nurse Practitioner | 7517221096 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704306156 | MI | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ear Nose and Throat Consultants PC | Current | Accepting new patients | |
| Melvin C. Murphy, M.D. P.C. | Past | Accepting new patients |
Locations
31450 7 Mile Rd
Livonia, MI 48152
Phone (248) 478-6363
27483 Dequindre Rd
Ste 201
Madison Hts, MI 48071
Phone (248) 541-0100
26850 Providence Pkwy
Ste 165
Novi, MI 48374
26110 Harper Ave
Saint Clair Shores, MI 48081
29201 Telegraph Rd
Ste 500
Southfield, MI 48034
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 4704306156 | MI | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
14575 Southfield Rd
Allen Park, MI 48101-2640
Mailing address
460 E Cambourne St
Ferndale, MI 48220-1306
Phone (248) 672-9442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 13, 2018.
{
"created_epoch": "1523577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523577600000",
"number": "1366949596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "460 E CAMBOURNE ST",
"city": "FERNDALE",
"state": "MI",
"postal_code": "482201306",
"telephone_number": "248-672-9442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14575 SOUTHFIELD RD",
"city": "ALLEN PARK",
"state": "MI",
"postal_code": "481012640",
"telephone_number": "313-381-8787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSMAN",
"first_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-13",
"last_updated": "2018-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MI",
"license": "4704306156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Allen Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.