Individual provider Active NPI

Jaime A Grossman, OD

  • Optometrist
  • Miami Beach, FL
National Provider Identifier
1891869053
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3117 Issued in FL
Practice address
542 Arthur Godfrey Rd
Miami Beach, FL 33140-3510
Phone
(305) 534-3937
NPI assigned
Nov 20, 2006
Last updated
Oct 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3117 FL Primary

Addresses

Primary practice location

542 Arthur Godfrey Rd
Miami Beach, FL 33140-3510

Mailing address

542 Arthur Godfrey Rd
Miami Beach, FL 33140-3510
Phone (305) 534-3937

Other practice location 1

138 E Fordham Rd
Bronx, NY 10468-5408
Phone (718) 933-0187

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240916001451 NY Practitioner - Optometry 1456347673 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005802NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Specs Inc Optometrist CurrentSince Aug 1, 2024 Accepting new patients
Pro Optics Corp Optometrist Past Accepting new patients
Sidney J Stern Visual Health Centers PA Optometrist Past Accepting new patients
519 Eyecare Inc. Optometrist Past Accepting new patients
Sidney J Stern Visual Health Centers PA Optometrist PastSince Nov 1, 2005 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1891869053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 ARTHUR GODFREY RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403510",
            "telephone_number": "305-534-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 ARTHUR GODFREY RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403510",
            "telephone_number": "305-534-3937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "138 E Fordham Rd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104685408",
            "country_code": "US",
            "telephone_number": "718-933-0187",
            "fax_number": "718-364-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "JAIME",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.