Individual provider Active NPI

Leonard A Grossman, M.D.

  • Rheumatology Physician
  • Princeton, NJ
National Provider Identifier
1578600136
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
25MA03747400 Issued in NJ
Practice address
419 N Harrison St
Princeton, NJ 08540-3521
Phone
(609) 924-9300
Fax
(609) 430-9481
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 25MA03747400 NJ Primary

Addresses

Primary practice location

419 N Harrison St
Princeton, NJ 08540-3521

Mailing address

419 N Harrison St
Princeton, NJ 08540-3521
Phone (609) 924-9300

Other identifiers 9

IdentifierTypeStateIssuer
0419803000OtherAMERIHLTH IBC PCP SPEC.
1547974OtherUNITED HEALTH CARE
160052226OtherRAILROAD MEDICARE
P441630OtherOXFORD PCP
854535OtherAETNA PCP
1651404MedicaidNJ
597405OtherAMERIHLTH ADMIN PCP SPEC
2195157OtherAETNA SPECIALTY
P1308108OtherOXFORD SPECIALTY

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
25MA03747400NJMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Medical Group, P.a. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1578600136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 N HARRISON ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403521",
            "telephone_number": "609-924-9300",
            "fax_number": "609-430-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 N HARRISON ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403521",
            "telephone_number": "609-924-9300",
            "fax_number": "609-430-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "LEONARD",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NJ",
            "license": "25MA03747400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHLTH IBC PCP SPEC.",
            "identifier": "0419803000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1547974",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160052226",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PCP",
            "identifier": "P441630",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PCP",
            "identifier": "854535",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1651404",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHLTH ADMIN PCP SPEC",
            "identifier": "597405",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALTY",
            "identifier": "2195157",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD SPECIALTY",
            "identifier": "P1308108",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.