Active NPI
Roger N Grossbard, O.D.
- Optometrist
- Surprise, AZ
National Provider Identifier
1790725851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1287
- Practice address
- 14455 W Grand Ave
Suite 102
Surprise, AZ 85374-7196 - Phone
- (623) 546-2080
- NPI assigned
- Jun 7, 2006
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1287 | AZ | Primary |
Addresses
Primary practice location
14455 W Grand Ave
Suite 102
Surprise, AZ 85374-7196
Mailing address
17492 N Horseshoe Dr
Surprise, AZ 85374-6238
Phone (623) 975-4422
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1287 | AZ | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family in Focus PLLC | Optometrist | Past | Accepting new patients |
| Robert a. Harper | Optometrist | Past | Accepting new patients |
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.
-
- Optometrist
- Sun City West, AZ
- NPI 1811618796
-
- Optometrist
- Sun City West, AZ
- NPI 1215152285
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192579200000",
"number": "1790725851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17492 N HORSESHOE DR",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853746238",
"telephone_number": "623-975-4422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14455 W GRAND AVE",
"address_2": "SUITE 102",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853747196",
"telephone_number": "623-546-2080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSBARD",
"first_name": "ROGER",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2007-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "1287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.