Individual provider Active NPI

Irina Grosman, M.D.

  • Therapeutic Radiology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1609820372
Registry record updated Nov 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Therapeutic Radiology PhysicianTaxonomy code 2085R0203X
License
ME 71096 Issued in FL
Practice address
4725 N Federal Hwy
Holy Cross Hospital Department of Radiation
Fort Lauderdale, FL 33308-4603
Phone
(954) 492-5764
Fax
(954) 776-3238
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Therapeutic Radiology Physician 2085R0203X ME 71096 FL Primary
Therapeutic Radiology Physician 2085R0203X 25MA06449800 NJ
Therapeutic Radiology Physician 2085R0203X 196838-1 NY
Therapeutic Radiology Physician 2085R0203X MD058312L PA

Addresses

Primary practice location

4725 N Federal Hwy
Holy Cross Hospital Department of Radiation
Fort Lauderdale, FL 33308-4603

Mailing address

405 N Ocean Blvd Apt 1501
Pompano Beach, FL 33062-5153
Phone (347) 400-0405

Other identifiers 1

IdentifierTypeStateIssuer
2743841 00MedicaidFL

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
ME 71096FLMDTherapeutic Radiology Physician
25MA06449800NJMDTherapeutic Radiology Physician
196838-1NYMDTherapeutic Radiology Physician
MD058312LPAMDTherapeutic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ijkg Opco LLC Current Accepting new patients
Radiation Oncology Associates of Ft Lauderdale PA Past Accepting new patients
Holy Cross Hospital, Inc Past Accepting new patients
Radiosurgery America PC Past Accepting new patients
Warwick Street Medical PC Past Accepting new patients
Tampa Bay Radiation Oncology, PA Therapeutic Radiology Past Accepting new patients
Heysek & Kepes MDS PA Past Accepting new patients
Holy Cross Hospital Inc Past Accepting new patients
Gilbert Lederman MD PC PastSince Mar 7, 2011 Accepting new patients
Mercy Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: irina.grosman@direct.bayonnemedicalcenter.md
  • FHIR API: https://fhir-myrecord.cerner.com/r4/_equjXi-I6k5_iN9ulQyh3xNMVDgQ7-w/

Organizations & group practices 10

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258070400000",
    "number": "1609820372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N OCEAN BLVD APT 1501",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330625153",
            "telephone_number": "347-400-0405",
            "fax_number": "954-785-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 N FEDERAL HWY",
            "address_2": "HOLY CROSS HOSPITAL DEPARTMENT OF RADIATION",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084603",
            "telephone_number": "954-492-5764",
            "fax_number": "954-776-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSMAN",
        "first_name": "IRINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2009-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "FL",
            "license": "ME  71096",
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "NJ",
            "license": "25MA06449800",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "NY",
            "license": "196838-1",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "PA",
            "license": "MD058312L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2743841  00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; 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.