Individual provider Active NPI

Michelle Grosso, PHYSICIAN ASSISTANT

  • Surgical Physician Assistant
  • Danbury, CT
National Provider Identifier
1629345053
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
001966 Issued in CT
Practice address
107 Newtown Rd Ste 2C
Danbury, CT 06810
Phone
(203) 791-9661
Fax
(203) 730-4162
NPI assigned
Nov 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 001966 CT Primary

Addresses

Primary practice location

107 Newtown Rd Ste 2C
Danbury, CT 06810

Mailing address

107 Newtown Rd Ste 2C
Danbury, CT 06810-4151
Phone (203) 791-9661

Other practice location 1

148 East Ave
Suite 1E
Norwalk, CT 06851-5721
Phone (203) 855-0167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20120330000120 CT Practitioner - Physician Assistant 4688834559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
JS Weill Medical College, Cornell University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Specialty Care, P.C.Group PAC ID 2567353121, 24 clinicians

Practice addresses (Care Compare)

107 Newtown Rd
Suite 2a
Danbury, CT 06810-4151
Phone (203) 830-4700

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101
  • Danbury Hospital Hospital, Danbury, CT, CCN 070033

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1966CTMDBehavioral Analyst
001966CTMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Connecticut Vascular Center, LLC Past Accepting new patients
Advanced Audiology & Hearing Aid Services Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michelle.grossopac.p1@direct.asc.nextgenshare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1629345053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 NEWTOWN RD STE 2C",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104151",
            "telephone_number": "203-791-9661",
            "fax_number": "203-730-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 NEWTOWN RD STE 2C",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06810",
            "telephone_number": "203-791-9661",
            "fax_number": "203-730-4162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "148 East Ave",
            "address_2": "Suite 1E",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CT",
            "postal_code": "068515721",
            "country_code": "US",
            "telephone_number": "203-855-0167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSSO",
        "first_name": "MICHELLE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "001966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.