Individual provider Active NPI

Bruce J. Grossman, MD

  • Pediatric Critical Care Medicine Physician
  • Neptune, NJ
National Provider Identifier
1720057409
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
25MA06628000 Issued in NJ
Practice address
1945 Route 33
Neptune, NJ 07753-4859
Phone
(732) 776-3890
Fax
(732) 776-2344
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 25MA06628000 NJ Primary

Addresses

Primary practice location

1945 Route 33
Neptune, NJ 07753-4859

Mailing address

1945 Route 33
Neptune, NJ 07753-4859
Phone (732) 776-3890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041202000618 NJ Practitioner - Pediatric Medicine 8426014333 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Feb 4, 2013 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Feb 4, 2013 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Apr 20, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Apr 20, 2023 Accepting new patients
Newark Beth Israel Medical Center Inc Past Accepting new patients
Nbimc Family Health Center Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

Interoperability endpoints

  • Direct secure messaging: bruce.grossman@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 6

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1720057409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 ROUTE 33",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534859",
            "telephone_number": "732-776-3890",
            "fax_number": "732-776-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 ROUTE 33",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534859",
            "telephone_number": "732-776-3890",
            "fax_number": "732-776-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "BRUCE",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NJ",
            "license": "25MA06628000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.