Individual provider Active NPI

Jesus A. Groso, M.D.

  • Family Medicine Physician
  • Okeechobee, FL
National Provider Identifier
1396714846
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME91183 Issued in FL
Practice address
1008 N Parrott Ave
Okeechobee, FL 34972-2110
Phone
(863) 610-3624
NPI assigned
Mar 16, 2006
Last updated
Aug 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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 ME91183 FL Primary

Addresses

Primary practice location

1008 N Parrott Ave
Okeechobee, FL 34972-2110

Mailing address

1008 N Parrott Ave
Okeechobee, FL 34972-2110
Phone (863) 610-3624

Other identifiers 2

IdentifierTypeStateIssuer
273222000MedicaidFL
48497OtherFLBCBS PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20051128000421 FL Practitioner - Family Practice 9436179108 Practice locations: Okeechobee, FL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1008 N Parrott Ave
Okeechobee, FL 34972-2110
Phone (863) 610-3624

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: j&igrosofamilymedicine.jesusgroso@142814.advancedmd-direct.com

Organizations & group practices 1

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.

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1396714846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N PARROTT AVE",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349722110",
            "telephone_number": "863-610-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N PARROTT AVE",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349722110",
            "telephone_number": "863-610-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSO",
        "first_name": "JESUS",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME91183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273222000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "48497",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okeechobee, FL

Sources for this page

Verify at the official NPI Registry.