Active NPI
Jay Grossman, MD
- Allergy Physician
- Oro Valley, AZ
National Provider Identifier
1467480855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- 20520
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 123662 | Medicaid | AZ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20520 | AZ | MD | Allergy Physician |
Practice roles
| Organization | Specialty | Status | New 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.