Individual provider Active NPI

Daniel K Grossman, MD

  • Emergency Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1386601326
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G67384 Issued in CA
Practice address
1328 Twenty Second St
Santa Monica, CA 90404-2091
Phone
(310) 582-7089
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G67384 CA Primary

Addresses

Primary practice location

1328 Twenty Second St
Santa Monica, CA 90404-2091

Mailing address

PO Box 12079
Westminster, CA 92685-3852
Phone (562) 809-3595

Other identifiers 1

IdentifierTypeStateIssuer
00G673840MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100617000714 CA Practitioner - Emergency Medicine 3870490733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G67384CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Johns Emergency Medicine Specialists Inc a Medical Group Emergency Medicine CurrentSince Oct 1, 1994 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jun 29, 2021 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jun 29, 2021 Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients
Providence Saint John'S Health Center Past Accepting new patients
UCLA Medical Group Emergency Medicine Past Accepting new patients

Locations

751 Medical Center Ct
#1182
Chula Vista, CA 91911

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1386601326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12079",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926853852",
            "telephone_number": "562-809-3595",
            "fax_number": "562-468-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 TWENTY SECOND ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042091",
            "telephone_number": "310-582-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "DANIEL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G67384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G673840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.