Individual provider Active NPI

Michael David Groshner

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1861929952
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
SL1203 Issued in NV
Practice address
620 Shadow LN
Las Vegas, NV 89106-4119
Phone
(702) 388-4000
NPI assigned
May 19, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X DO2637 NV
Internal Medicine Physician 207R00000X SL1203 NV Primary

Addresses

Primary practice location

620 Shadow LN
Las Vegas, NV 89106-4119

Mailing address

620 Shadow LN
Las Vegas, NV 89106-4119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20201015001215 AZ Practitioner - Internal Medicine 7719257740 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aia Hospitalists LLCGroup PAC ID 3375583636, 51 clinicians
Carelon Medical Partners of Arizona PCGroup PAC ID 6406010552, 15 clinicians

Practice addresses (Care Compare)

4530 E Muirwood Dr
Suite 105
Phoenix, AZ 85048-7693
Phone (480) 961-2303

7091 E Speedway Blvd
Tucson, AZ 85710-1241
Phone (520) 721-5777

Hospital & facility affiliations

  • Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO2637NVMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carelon Medical Partners of Arizona, P.C. Family Medicine CurrentSince Feb 1, 2021 Accepting new patients
Carelon Medical Partners of Arizona, P.C. Family Medicine CurrentSince Feb 1, 2021 Accepting new patients
Aia Hospitalists LLC Internal Medicine CurrentSince Nov 15, 2022 Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

4530 E Muirwood Dr
Ste 105
Phoenix, AZ 85048
Phone (480) 961-2303

4821 N Stone Ave
Tucson, AZ 85704
Phone (520) 314-3300

7091 E Speedway Blvd
Tucson, AZ 85710
Phone (520) 402-6092

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

Interoperability endpoints

  • Direct secure messaging: michael.groshner.p1@direct.caremorewest.nextgenshare.com
  • Direct secure messaging: michael.groshner.p4@direct.caremorewest.nextgenshare.com
  • Direct secure messaging: michael.groshner.1@32527.direct.athenahealth.com

Organizations & group practices 4

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.

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": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1861929952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064119",
            "telephone_number": "702-388-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSHNER",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-19",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NV",
            "license": "DO2637",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "SL1203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.