Individual provider Active NPI

Tawny Minna Grossman, NP

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1649666298
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001921 Issued in CA
Practice address
6400 E Pacific Coast Hwy Ste D210
Long Beach, CA 90803-4265
Phone
(415) 658-6791
NPI assigned
Apr 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95001921 CA Primary

Addresses

Primary practice location

6400 E Pacific Coast Hwy Ste D210
Long Beach, CA 90803-4265

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170830001003 CA Practitioner - Nurse Practitioner 2163795980 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14443 Culver Dr
14443 A
Irvine, CA 92604-0343
Phone (949) 767-8173

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of California PC CurrentSince Nov 22, 2024 Accepting new patients
Carbon Health Medical Group of California PC CurrentSince Nov 22, 2024 Accepting new patients
Providence Saint Johns Medical Foundation CurrentSince Mar 1, 2021 Accepting new patients
Hoag Clinic CurrentSince Apr 10, 2019 Accepting new patients

Locations

13299 South St
Cerritos, CA 90703
Phone (562) 865-8750

3195 Harbor Blvd
Ste 3
Costa Mesa, CA 92626
Phone (714) 263-0227

10165 Valley View St
Cypress, CA 90630
Phone (657) 348-2427

14443 Culver Dr
#14443A
Irvine, CA 92604
Phone (949) 767-8173

6340 Irvine Blvd
Irvine, CA 92620
Phone (949) 559-6500

14443 Culver Dr
Ste 14443A
Irvine, CA 92604

1040 W Imperial Hwy
Ste D
La Habra, CA 90631
Phone (714) 451-1072

3851 Katella Ave
Ste 100
Los Alamitos, CA 90720
Phone (562) 424-5450

858 N Rose Dr
Ste C2
Placentia, CA 92870
Phone (714) 792-3736

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2944 Tapo Canyon Rd
Ste A
Simi Valley, CA 93063
Phone (805) 306-5990

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1649666298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 E PACIFIC COAST HWY STE D210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034265",
            "telephone_number": "415-658-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "TAWNY",
        "middle_name": "MINNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.