Active NPI
Jeremy Ian Grosser MD Inc.
- Internal Medicine Physician
- Canoga Park, CA
National Provider Identifier
1669484481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A67128
- Legal business name
- JEREMY IAN GROSSER MD INC.
- Practice address
- 7355 Topanga Canyon Blvd Ste 200
Canoga Park, CA 91303-1244 - Phone
- (818) 885-8500
- Fax
- (818) 700-5690
- NPI assigned
- Aug 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jeremy Ian Grosser, MD
- Title
- President
- Phone
- (818) 929-2259
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A67128 | CA | Primary |
Addresses
Primary practice location
7355 Topanga Canyon Blvd Ste 200
Canoga Park, CA 91303-1244
Mailing address
109 Dapplegray Rd
Bell Canyon, CA 91307-1050
Phone (818) 929-2259
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Jeremy Ian Grosser MD Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Medical Specialty Clinic/Center
- Canoga Park, CA
- NPI 1174702377
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Canoga Park, CA
- NPI 1235123373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1662249600000",
"number": "1669484481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 DAPPLEGRAY RD",
"city": "BELL CANYON",
"state": "CA",
"postal_code": "913071050",
"telephone_number": "818-929-2259",
"fax_number": "818-700-5690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7355 TOPANGA CANYON BLVD STE 200",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913031244",
"telephone_number": "818-885-8500",
"fax_number": "818-700-5690"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JEREMY IAN GROSSER MD INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-12",
"last_updated": "2022-09-04",
"certification_date": "2022-09-04",
"status": "A",
"authorized_official_last_name": "GROSSER",
"authorized_official_first_name": "JEREMY",
"authorized_official_middle_name": "IAN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "818-929-2259",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "CA",
"license": "A67128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canoga Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.