Individual provider Active NPI

Chana Grossman

  • Family Nurse Practitioner
  • Vineland, NJ
National Provider Identifier
1609382928
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ14927200 Issued in NJ
Practice address
1103 W Sherman Ave Ste 2B
Vineland, NJ 08360-6912
Phone
(877) 388-2778
Fax
(856) 213-4036
NPI assigned
Dec 21, 2017
Last updated
Mar 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ14927200 NJ Primary
Family Nurse Practitioner 363LF0000X SP022943 PA
Family Nurse Practitioner 363LF0000X 342426 NY

Addresses

Primary practice location

1103 W Sherman Ave Ste 2B
Vineland, NJ 08360-6912

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Other practice location 1

6608 Castor Ave
Philadelphia, PA 19149-2120
Phone (215) 342-7710

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240318003031 NJ Practitioner - Nurse Practitioner 4688011356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ14927200NJMDFamily Nurse Practitioner
342426NYMDFamily Nurse Practitioner
SP022943PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Feb 5, 2024 Accepting new patients
E&M Healthcare CurrentSince Aug 1, 2021 Accepting new patients
New Jersey Urology LLC CurrentSince Mar 12, 2024 Accepting new patients
Summit Medical Group PA CurrentSince Feb 5, 2024 Accepting new patients
Castor Pediatrics PC PastSince Aug 1, 2021 Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

1103 W Sherman Ave
Ste 2B
Vineland, NJ 08360
Phone (856) 213-4035

6608 Castor Ave
Philadelphia, PA 19149
Phone (215) 342-7710

Interoperability endpoints

  • Direct secure messaging: chana.grossman@castoravenuepediatrics.chartmakerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1609382928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 W SHERMAN AVE STE 2B",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606912",
            "telephone_number": "877-388-2778",
            "fax_number": "856-213-4036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6608 Castor Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191492120",
            "country_code": "US",
            "telephone_number": "215-342-7710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "CHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14927200",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022943",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342426",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.