Organization Active NPI

Alan Gruskin DO PA

  • Physical Medicine & Rehabilitation Physician
  • Tamarac, FL
National Provider Identifier
1376849679
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
OS4832 Issued in FL
Legal business name
ALAN GRUSKIN DO PA
Practice address
7401 N University Dr
Suite 106
Tamarac, FL 33321-2979
Phone
(954) 722-6777
Fax
(954) 722-6405
NPI assigned
Feb 3, 2011
Last updated
Feb 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Authorized official

Name
Dr. Alan Gruskin, DONPI 1174586515
Title
President
Phone
(954) 722-6777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X OS4832 FL Primary

Addresses

Primary practice location

7401 N University Dr
Suite 106
Tamarac, FL 33321-2979

Mailing address

7401 N University Dr
Suite 106
Tamarac, FL 33321-2979
Phone (954) 722-6777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110609000203 FL Part B Supplier - Clinic/Group Practice 1850578303 Receives reassigned benefits from 1 practitioner
Practice locations: Boca Raton, FL; Tamarac, FL

National Provider Directory

National Provider Directory

Locations

900 NW 13th St
Ste 104
Boca Raton, FL 33486
Phone (561) 394-0214

7401 N University Dr
Ste 106
Tamarac, FL 33321
Phone (954) 722-6777

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296691200000",
    "number": "1376849679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 N UNIVERSITY DR",
            "address_2": "SUITE 106",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212979",
            "telephone_number": "954-722-6777",
            "fax_number": "954-722-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 N UNIVERSITY DR",
            "address_2": "SUITE 106",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212979",
            "telephone_number": "954-722-6777",
            "fax_number": "954-722-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN GRUSKIN DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-03",
        "last_updated": "2011-02-03",
        "status": "A",
        "authorized_official_last_name": "GRUSKIN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-722-6777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "OS4832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.