Individual provider Active NPI

Scott Grossman, OD PA

  • Optometrist
  • Miami, FL
National Provider Identifier
1750484564
Registry record updated Aug 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4188 Issued in FL
Practice address
18557 W Dixie Hwy
Miami, FL 33180-2614
Phone
(305) 466-0777
Fax
(305) 466-0773
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4188 FL Primary

Addresses

Primary practice location

18557 W Dixie Hwy
Miami, FL 33180-2614

Mailing address

18557 W Dixie Hwy
Miami, FL 33180-2614
Phone (305) 466-0777

Other identifiers 1

IdentifierTypeStateIssuer
621143700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070405000037 FL Practitioner - Optometry 5698879328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18557 W Dixie Hwy
Suite a
Miami, FL 33180-3603
Phone (305) 466-0777

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Scott Grossman OD PA Optometrist CurrentSince Nov 3, 2008 Accepting new patients
Dr Alan Grossman PA Optometrist Past Accepting new patients

Locations

18557 W Dixie Hwy
Ste A
Miami, FL 33180
Phone (305) 466-0777

18557 W Dixie Hwy
Miami, FL 33180
Phone (305) 466-0777

Organizations & group practices 2

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1750484564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18557 W DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331802614",
            "telephone_number": "305-466-0777",
            "fax_number": "305-466-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18557 W DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331802614",
            "telephone_number": "305-466-0777",
            "fax_number": "305-466-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "OD PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621143700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.