Individual provider Active NPI

Lisa Hope Grossman, PA

  • Physician Assistant
  • Pompano Beach, FL
National Provider Identifier
1619070828
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA107970 Issued in FL
Practice address
1611 S Federal Hwy
Pompano Beach, FL 33062-7514
Phone
(954) 580-4001
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA107970 FL Primary

Addresses

Primary practice location

1611 S Federal Hwy
Pompano Beach, FL 33062-7514

Mailing address

1611 S Federal Hwy
Pompano Beach, FL 33062-7514
Phone (954) 580-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210108001017 FL Practitioner - Physician Assistant 2769802149 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solantic/South Florida LLCGroup PAC ID 5496762171, 27 clinicians

Practice addresses (Care Compare)

1205 N University Dr
Coral Springs, FL 33071-6620
Phone (954) 780-8134

1611 S Federal Hwy
Pompano Beach, FL 33062-7514
Phone (954) 580-4001

4450 N State Rd
7 Suite 1
Coral Springs, FL 33073-3354
Phone (954) 633-1422

9035 Pines Blvd
Pembroke Pines, FL 33024-6440
Phone (954) 378-0333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA107970FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Outpatient Services Inc CurrentSince Jan 11, 2021 Accepting new patients
Bayside Chiropractic, LLC Past Accepting new patients

Locations

6264 W Sample Rd
Ste 120
Coral Springs, FL 33067
Phone (954) 837-1020

8950 N Kendall Dr
Fl 2
Miami, FL 33176
Phone (786) 596-7200

Organizations & group practices 8

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1619070828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S FEDERAL HWY",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330627514",
            "telephone_number": "954-580-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S FEDERAL HWY",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330627514",
            "telephone_number": "954-580-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "LISA",
        "middle_name": "HOPE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2021-12-02",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA107970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.