Individual provider Active NPI

Michael J Grossman, M.D.

  • Obstetrics & Gynecology Physician
  • North Andover, MA
National Provider Identifier
1831188218
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
48692 Issued in MA
Practice address
565 Turnpike St
Suite 74
North Andover, MA 01845-5922
Phone
(978) 682-2121
NPI assigned
Oct 18, 2005
Last updated
Feb 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 48692 MA Primary

Addresses

Primary practice location

565 Turnpike St
Suite 74
North Andover, MA 01845-5922

Mailing address

PO Box 307
Andover, MA 01810-0006
Phone (978) 682-2121

Other identifiers 2

IdentifierTypeStateIssuer
J03100OtherMEDICARE
3131696MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040805001251 MA Practitioner - Obstetrics/Gynecology 3971574401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Georgetown University School of Medicine, 1977
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

565 Turnpike St
North Andover, MA 01845-5922
Phone (978) 682-2121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48692MAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Diagnostic Services, Inc CurrentSince Jan 1, 2008 Accepting new patients
Michael J Grossman MD PC Obstetrics & Gynecology CurrentSince Aug 28, 2012 Accepting new patients
LG Newcorp Inc Past Accepting new patients
Lawrence General Hospital Past Accepting new patients

Locations

565 Turnpike St
North Andover, MA 01845
Phone (978) 681-1212

565 Turnpike St
Ste 74
North Andover, MA 01845
Phone (978) 682-2121

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GBIEBA/Endpoint/GBIEBA
  • Direct secure messaging: michael.grossman@mic.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1831188218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018100006",
            "telephone_number": "978-682-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 TURNPIKE ST",
            "address_2": "SUITE 74",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455922",
            "telephone_number": "978-682-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "48692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "J03100",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3131696",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.