Lee Jay Grossbard, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME44251 Issued in FL

Practice address

13933 17TH St
Suite 200
Dade City, FL 33525-4604

Phone

(352) 437-5971

NPI assigned

Aug 16, 2005

Reactivated

Mar 29, 2006

Last updated

Jul 28, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Florida Hospital Physician Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256

  Surgery

  NPD (past)
• North Tampa Outpatient Surgical Facility LLC

  • Ambulatory Surgical Clinic/Center
  • Tampa, FL
  • NPI 1912104787
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1730171786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13933 17TH ST",
            "address_2": "SUITE 200",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335254604",
            "telephone_number": "352-437-5971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13933 17TH ST",
            "address_2": "SUITE 200",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335254604",
            "telephone_number": "352-437-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSBARD",
        "first_name": "LEE",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2015-07-28",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME44251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "00639",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3705092",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "51224",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTHCARE",
            "identifier": "0623994",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "203003",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "200072",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "020018581",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anabel Gonzalez
• Dinah Deal Grant, RN
• Tanisha Grant, PMHNP-C
• Groomes Dental P.a.
• Rebecca F Groomes, D.D.S.
• Mary Gude, RPH
• Hector Esteban Guevara-Garay, M.D.
• Gulf-to-Bay Anesthesiology Associates LLC
• Miranda Kristen Hager, LMHC
• Madisyn Haney, BCBA

• Surgery Physician in Dade City, FL
• Providers in Dade City, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.