Individual provider Active NPI

Jason A Grotas, MD

  • Urology Physician
  • Lawrence, NY
National Provider Identifier
1922092295
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
NY235437 Issued in NY
Practice address
290 Central Ave Ste 207
Lawrence, NY 11559-8507
Phone
(516) 239-8585
Fax
(516) 239-8529
NPI assigned
Sep 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NY235437 NY Primary

Addresses

Primary practice location

290 Central Ave Ste 207
Lawrence, NY 11559-8507

Mailing address

290 Central Ave Ste 207
Lawrence, NY 11559-8507
Phone (516) 239-8585

Other identifiers 1

IdentifierTypeStateIssuer
026631MedicaidNY

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050920000103 NY Practitioner - Urology 8820021157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Rowan University School of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

290 Central Ave
Lawrence, NY 11559-8507
Phone (516) 239-8585

327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone (516) 239-8585

Hospital & facility affiliations

  • St John'S Episcopal Hospital at South Shore Hospital, Far Rockaway, NY, CCN 330395
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NY235437NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urologic Surgical Care LLC CurrentSince Jul 7, 2024 Accepting new patients
Urologic Surgical Care PLLC Urology CurrentSince Aug 1, 2005 Accepting new patients
South Ocean Care LLC Past Accepting new patients

Locations

3079 Brighton 13th St
Brooklyn, NY 11235
Phone (718) 554-3862

290 Central Ave
Ste 207
Lawrence, NY 11559
Phone (516) 239-8585

27005 76th Ave
North New Hyde Pk, NY 11040

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1922092295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 CENTRAL AVE STE 207",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115598507",
            "telephone_number": "516-239-8585",
            "fax_number": "516-239-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CENTRAL AVE STE 207",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115598507",
            "telephone_number": "516-239-8585",
            "fax_number": "516-239-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTAS",
        "first_name": "JASON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "NY235437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026631",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

Verify at the official NPI Registry.