Individual provider Active NPI

Robert B Grossman, MD

  • Pulmonary Disease Physician
  • Woodbury, NY
National Provider Identifier
1922054709
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
128011 Issued in NY
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

Updated by the provider on May 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00867661MedicaidNY

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

LicenseStateTypeSpecialty
128011NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.