Individual provider Active NPI

Lisa Maria Perez-Grossman, M.D. P.A.

  • Pediatrics Physician
  • Miami, FL
National Provider Identifier
1871581447
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME71327 Issued in FL
Practice address
1235 SW 87TH Ave
Miami, FL 33174-3306
Phone
(305) 269-1990
Fax
(305) 269-1970
NPI assigned
Oct 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME71327 FL Primary

Addresses

Primary practice location

1235 SW 87TH Ave
Miami, FL 33174-3306

Mailing address

1235 SW 87TH Ave
Miami, FL 33174-3306
Phone (305) 269-1990

Other identifiers 1

IdentifierTypeStateIssuer
254822400MedicaidFL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170510001902 FL Practitioner - Pediatric Medicine 3274810742 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC Pediatrics CurrentSince Feb 21, 2017 Accepting new patients

Locations

1235 SW 87th Ave
Miami, FL 33174
Phone (305) 269-1990

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

Interoperability endpoints

  • Direct secure messaging: lisaperezgross@sevgrossman.sevocitydirect.com

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

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1871581447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 SW 87TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331743306",
            "telephone_number": "305-269-1990",
            "fax_number": "305-269-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 SW 87TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331743306",
            "telephone_number": "305-269-1990",
            "fax_number": "305-269-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-GROSSMAN",
        "first_name": "LISA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.  P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-07",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME71327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254822400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.