Individual provider Active NPI

Cheryl Renee Grossman, PAC

  • Physician Assistant
  • Towson, MD
National Provider Identifier
1700842762
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0001112 Issued in MD
Practice address
515 Fairmount Ave Ste 400
Towson, MD 21286-8518
Phone
(410) 494-1313
Fax
(410) 584-2250
NPI assigned
Apr 26, 2006
Last updated
Nov 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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 C0001112 MD Primary

Addresses

Primary practice location

515 Fairmount Ave Ste 400
Towson, MD 21286-8518

Mailing address

515 Fairmount Ave
Ste 400
Towson, MD 21286-5466
Phone (410) 494-1324

Other identifiers 1

IdentifierTypeStateIssuer
798621100MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cheryl.grossman.p2@direct.clinicalassociates.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20110228000422 MD Practitioner - Physician Assistant 5799966586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Clinical Associates P aGroup PAC ID 1254631005, 44 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

1838 Greene Tree Rd
Pikesville, MD 21208-7108
Phone (443) 471-0460

515 Fairmount Ave
Towson, MD 21286-5466
Phone (410) 296-5300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.85 of 100Reported as group
Quality
80.72
Promoting interoperability
79
Improvement activities
40
Cost
76.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0001112MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Associates PA CurrentSince Jan 1, 2016 Accepting new patients
Clinical Associates P a Physician Assistant CurrentSince Jan 1, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1838 Greene Tree Rd
Ste 135
Pikesville, MD 21208
Phone (443) 471-0460

515 Fairmount Ave
Ste 330
Towson, MD 21286
Phone (410) 296-5300

515 Fairmount Ave
Ste 400
Towson, MD 21286
Phone (410) 494-1324

7600 Osler Dr
Ste 407
Towson, MD 21204
Phone (410) 321-9108

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1700842762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE",
            "address_2": "STE 400",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865466",
            "telephone_number": "410-494-1324",
            "fax_number": "410-494-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE STE 400",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212868518",
            "telephone_number": "410-494-1313",
            "fax_number": "410-584-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "CHERYL",
        "middle_name": "RENEE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0001112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "798621100",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cheryl.grossman.p2@direct.clinicalassociates.nextgenshare.com",
            "affiliation": "N",
            "address_1": "515 Fairmount Ave Ste 400",
            "city": "Towson",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212868518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.