Individual provider Active NPI

Roksana Grozeva, PA

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1861878233
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7622 Issued in GA
Practice address
900 Mohawk St Ste a
Savannah, GA 31419-1772
Phone
(912) 920-2090
NPI assigned
Aug 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7622 GA Primary

Addresses

Primary practice location

900 Mohawk St Ste a
Savannah, GA 31419-1772

Mailing address

900 Mohawk St Ste a
Savannah, GA 31419-1772
Phone (912) 920-2090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151106001242 GA Practitioner - Physician Assistant 1759691553 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7622GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Renewalmd Statesboro 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.

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1861878233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MOHAWK ST STE A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191772",
            "telephone_number": "912-920-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MOHAWK ST STE A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191772",
            "telephone_number": "912-920-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROZEVA",
        "first_name": "ROKSANA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.