Active NPI
Robert B Grossman, MD
- Pulmonary Disease Physician
- Woodbury, NY
National Provider Identifier
1922054709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 128011
- Practice address
- 43 Crossways Park Dr W
Woodbury, NY 11797-2002 - Phone
- (516) 992-5230
- Fax
- (516) 938-3239
- NPI assigned
- May 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 128011 | NY | Primary |
Addresses
Primary practice location
43 Crossways Park Dr W
Woodbury, NY 11797-2002
Mailing address
43 Crossways Park Dr W
Woodbury, NY 11797-2002
Phone (516) 992-5230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00867661 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 128011 | NY | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Queens Long Island Medical Group, P.C. | Pulmonary Disease | Current | Accepting new patients |
Locations
350 S Broadway
Hicksville, NY 11801
Phone (516) 733-8085
300 Bay Shore Rd
North Babylon, NY 11703
Phone (631) 586-2700
260 W Sunrise Hwy
Valley Stream, NY 11581
Phone (516) 791-4600
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- New York, NY
- NPI 1891732038
Pulmonary Disease
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306454400000",
"number": "1922054709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 CROSSWAYS PARK DR W",
"city": "WOODBURY",
"state": "NY",
"postal_code": "117972002",
"telephone_number": "516-992-5230",
"fax_number": "516-938-3239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 CROSSWAYS PARK DR W",
"city": "WOODBURY",
"state": "NY",
"postal_code": "117972002",
"telephone_number": "516-992-5230",
"fax_number": "516-938-3239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSMAN",
"first_name": "ROBERT",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2011-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "128011",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00867661",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Woodbury, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.