Individual provider Active NPI

Daniel Mark Gromis, MD

  • Emergency Medicine Physician
  • Costa Mesa, CA
National Provider Identifier
1487883146
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A120000 Issued in CA
Practice address
217 Rochester St
Unit B
Costa Mesa, CA 92627-3181
Phone
(949) 466-2177
NPI assigned
Jul 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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 A120000 CA Primary

Addresses

Primary practice location

217 Rochester St
Unit B
Costa Mesa, CA 92627-3181

Mailing address

217 Rochester St
Unit B
Costa Mesa, CA 92627-3181
Phone (949) 466-2177

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
I20120607000523 CA Practitioner - Emergency Medicine 9335314509 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Irvine, California College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Specialists of Orange CountyGroup PAC ID 0840185005, 43 clinicians

Practice addresses (Care Compare)

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111

Hospital & facility affiliations

  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A120000CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Group of Encinitas, Inc Emergency Medicine CurrentSince Nov 28, 2016 Accepting new patients
Emergency Medicine Specialists of Orange County Emergency Medicine CurrentSince Jul 1, 2012 Accepting new patients
La Jolla Observation Medicine Emergency Medicine CurrentSince Apr 3, 2017 Accepting new patients
Columbia Emergency Medical Group Inc Emergency Medicine CurrentSince May 1, 2013 Accepting new patients

Locations

354 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 230-2251

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

Organizations & group practices 5

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.

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": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1487883146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 ROCHESTER ST",
            "address_2": "UNIT B",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273181",
            "telephone_number": "949-466-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 ROCHESTER ST",
            "address_2": "UNIT B",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273181",
            "telephone_number": "949-466-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROMIS",
        "first_name": "DANIEL",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A120000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.