Robert H Grozalis Jr., MS

Primary specialty

AudiologistTaxonomy code 231H00000X

License

AT005886 Issued in PA

Practice address

680 Heacock Rd
Suite 203
Yardley, PA 19067

Phone

(215) 321-2337

Fax

(215) 321-2339

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871699686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 HEACOCK RD",
            "address_2": "SUITE 203",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "19067",
            "telephone_number": "215-321-2337",
            "fax_number": "215-321-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 HEACOCK RD",
            "address_2": "SUITE 203",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "19067",
            "telephone_number": "215-321-2337",
            "fax_number": "215-321-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROZALIS",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT005886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BC",
            "identifier": "2342258000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3573618",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011559410001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.