Michael R Grossman, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

10463 Issued in OK

Practice address

330 S 5TH St
Enid, OK 73701-5825

Phone

(580) 249-3003

Fax

(580) 599-6447

NPI assigned

Oct 17, 2005

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Farmers Union Hospital Association

  dba Great Plains Pat Wall Clinic

  • Rural Health Clinic/Center
  • Elk City, OK
  • NPI 1114421492
  NPD
• Farmers Union Hospital Association

  dba Great Plains Regional Medical Center

  • General Acute Care Hospital
  • Elk City, OK
  • NPI 1184639122
  NPD
• Union Associated Physicians Clinic LLC

  • Dermatology Physician
  • Terre Haute, IN
  • NPI 1407404940
  NPD
• Union Associated Physicians Clinic, LLC

  • Family Medicine Physician
  • Terre Haute, IN
  • NPI 1891028379
  NPD
• Ghazi M. Rayan, MD, Inc.

  • Orthopaedic Surgery Physician
  • Oklahoma City, OK
  • NPI 1972807667
  NPD (past)
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Lawton Urology

  • Urology Physician
  • Lawton, OK
  • NPI 1760997092
  NPD (past)
• Artesia General Hospital

  • General Acute Care Hospital
  • Artesia, NM
  • NPI 1437286044
  NPD (past)

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1538158233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3046",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193550746",
            "telephone_number": "580-249-3003",
            "fax_number": "580-599-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S 5TH ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015825",
            "telephone_number": "580-249-3003",
            "fax_number": "580-599-6447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 E Clark Bass Blvd",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "McAlester",
            "state": "OK",
            "postal_code": "745014282",
            "country_code": "US",
            "telephone_number": "918-421-6846",
            "fax_number": "918-421-6875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OK",
            "license": "10463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "1E4684",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100013500A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2 E Clark Bass Blvd",
            "address_2": "Suite 301",
            "city": "McAlester",
            "state": "OK",
            "country_code": "US",
            "postal_code": "745014282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Danesa Griffin
• Shereen Griffin
• Talisha Griffin
• Lisa Renee Grimes, D.D.S.
• Jennifer S Grittman
• Charles Raymond Kondo Grothe, DDS
• Cody Wayne Groves, MS, LPC CANDIDATE
• Sharon Groves
• Josh Guinn
• Aranda Gulick

• Gastroenterology Physician in Enid, OK
• Providers in Enid, OK by specialty
• Gastroenterology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.