Individual provider Active NPI

Rachel M Grossman, M.D.

  • Dermatology Physician
  • Princeton, NJ
National Provider Identifier
1548225477
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA06323600 Issued in NJ
Practice address
208 Bunn Dr
Princeton, NJ 08540-2851
Phone
(609) 683-4999
Fax
(609) 683-0298
NPI assigned
Apr 20, 2006
Last updated
Feb 14, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25MA06323600 NJ Primary

Addresses

Primary practice location

208 Bunn Dr
Princeton, NJ 08540-2851

Mailing address

208 Bunn Dr
Princeton, NJ 08540-2851
Phone (609) 683-4999

Other identifiers 1

IdentifierTypeStateIssuer
223777703OtherCOMMERCIAL INSURANCES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20101115000097 NJ Practitioner - Dermatology 8820283047 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Dermatology Associates PC Dermatology CurrentSince Jun 9, 2003 Accepting new patients
Princeton Dermatology Associates Kendall Parkpc Dermatology Past Accepting new patients

Locations

208 Bunn Dr
Princeton, NJ 08540
Phone (609) 683-4999

301 N Harrison St
Ste 1E
Princeton, NJ 08540
Phone (609) 683-4999

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1548225477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 BUNN DR",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402851",
            "telephone_number": "609-683-4999",
            "fax_number": "609-683-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 BUNN DR",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402851",
            "telephone_number": "609-683-4999",
            "fax_number": "609-683-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "RACHEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA06323600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCES",
            "identifier": "223777703",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.