Active NPI
Ira C Grossman, MD
- Urology Physician
- Plains, PA
National Provider Identifier
1740371970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MD018268E
- Practice address
- 670 S River St Ste 301
Plains, PA 18705-1032 - Phone
- (570) 270-2600
- Fax
- (570) 270-2828
- NPI assigned
- Sep 26, 2006
- Last updated
- Feb 5, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD018268E | PA | Primary |
Addresses
Primary practice location
670 S River St Ste 301
Plains, PA 18705-1032
Mailing address
670 S River St Ste 301
Plains, PA 18705-1032
Phone (570) 270-2600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0007116840001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD018268E | PA | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517788800000",
"number": "1740371970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 S RIVER ST STE 301",
"city": "PLAINS",
"state": "PA",
"postal_code": "187051032",
"telephone_number": "570-270-2600",
"fax_number": "570-270-2828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "670 S RIVER ST STE 301",
"city": "PLAINS",
"state": "PA",
"postal_code": "187051032",
"telephone_number": "570-270-2600",
"fax_number": "570-270-2828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSMAN",
"first_name": "IRA",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2018-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "PA",
"license": "MD018268E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0007116840001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plains, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.