Individual provider Active NPI

Jay Grossman, MD

  • Allergy Physician
  • Oro Valley, AZ
National Provider Identifier
1467480855
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
20520 Issued in AZ
Practice address
1521 E Tangerine Rd
Suite 311
Oro Valley, AZ 85755-6225
Phone
(520) 797-3111
Fax
(520) 326-2575
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 20520 AZ Primary

Addresses

Primary practice location

1521 E Tangerine Rd
Suite 311
Oro Valley, AZ 85755-6225

Mailing address

PO Box 2425
Skyland, NC 28776-2425
Phone (828) 277-1300

Other identifiers 1

IdentifierTypeStateIssuer
123662MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20520AZMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NPI 1508468638 Past Accepting new patients

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1467480855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2425",
            "city": "SKYLAND",
            "state": "NC",
            "postal_code": "287762425",
            "telephone_number": "828-277-1300",
            "fax_number": "828-277-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 E TANGERINE RD",
            "address_2": "SUITE 311",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857556225",
            "telephone_number": "520-797-3111",
            "fax_number": "520-326-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "AZ",
            "license": "20520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123662",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oro Valley, AZ

Sources for this page

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

Verify at the official NPI Registry.