NPIMap

Individual provider Active NPI

Kaitlyn May Grossman, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1407548886
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
030405 Issued in NY
Practice address
1 Gustave L Levy PL FL 12
New York, NY 10029-6574
Phone
(212) 241-6500
NPI assigned
May 23, 2023
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 030405 NY Primary
Medical Physician Assistant 363AM0700X NU
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1 Gustave L Levy PL FL 12
New York, NY 10029-6574

Mailing address

2320 Sheffield Rd
Charlottesville, VA 22901-7730

Other practice location 1

2320 Sheffield Rd
Charlottesville, VA 22901-7730
Phone (434) 242-7413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230927000337 NY Practitioner - Physician Assistant 9830543750 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 6103251491, 50 clinicians

Practice addresses (Care Compare)

234 E 85TH St
New York, NY 10028-3001
Phone (646) 605-5669

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 9, 2023 Accepting new patients
Fpa Hospital Based CurrentSince Oct 9, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 9, 2023 Accepting new patients
Fpa Hospital Based CurrentSince Oct 9, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1 Gustave L Levy Pl
Fl 12
New York, NY 10029
Phone (212) 241-1518

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

150 E 42nd St
#1623
New York, NY 10017

234 E 85th St
New York, NY 10028
Phone (212) 241-6585

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 9

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 6

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": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1407548886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 SHEFFIELD RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229017730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-241-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2320 Sheffield Rd",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229017730",
            "country_code": "US",
            "telephone_number": "434-242-7413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "KAITLYN",
        "middle_name": "MAY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030405",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.