Alexandra Grob, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS17608 Issued in FL

Practice address

905 W Platt St
Tampa, FL 33606-2113

Phone

(813) 336-7688

NPI assigned

Jun 18, 2012

Last updated

Dec 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 14, 2025 through Feb 14, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Derma Direct PLLC

  • Dermatology Physician
  • Tampa, FL
  • NPI 1912856543
  NPD Authorized official
• Spencer Dermatology & Skin Surgery Center LLC

  • Specialist
  • St Petersburg, FL
  • NPI 1104023324
  NPD

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1588927354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 W PLATT ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062113",
            "telephone_number": "813-336-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 W PLATT ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062113",
            "telephone_number": "813-336-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROB",
        "first_name": "ALEXANDRA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101020085",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5101020085",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MB09882600",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS17608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Raeann Grinstead, PHARMD
• Payton Gripp, APRN
• Hannah Grisack
• Dario Aquiles Grisales, M.D.
• Lori D Grismore, OT
• Stacey Grocke
• Lewis Groden, MD
• Kace Groff, D.C.
• Kaylee Marie Groff, D.C.
• Sherry Groff, LMT, MMP

• Dermatology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.