Individual provider Active NPI

Laurance Grossman, MD

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1942230347
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
234320-1 Issued in NY
Practice address
630 W 168TH St # MC28
New York, NY 10032-3725
Phone
(212) 305-1948
Fax
(212) 305-5777
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 234320-1 NY Primary

Addresses

Primary practice location

630 W 168TH St # MC28
New York, NY 10032-3725

Mailing address

630 W 168TH St # MC28
New York, NY 10032-3725
Phone (212) 305-1948

Other identifiers 3

IdentifierTypeStateIssuer
02603625MedicaidNY
W35021OtherNYMEDICARE GROUP #
02186203OtherNYMEDICAID GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20051109000635 OH Practitioner - Diagnostic Radiology 8729043690 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Ohio State University College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinic Medical Services CompanyGroup PAC ID 5698674653, 201 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-2262

6780 Mayfield Rd
Mayfield Heights, OH 44124-2203

6803 Mayfield Rd
Mayfield Heights, OH 44124-2271
Phone (440) 312-4500

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234320-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Wooster Clinic, LLC CurrentSince Dec 23, 2014 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Nov 15, 2005 Accepting new patients
Clinic Medical Services Company LLC Diagnostic Radiology CurrentSince Aug 1, 2005 Accepting new patients
Clinic Medical Services Company Diagnostic Radiology CurrentSince Aug 1, 2005 Accepting new patients
Open MRI of Steubenville, LTD Past Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology Past Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology Past Accepting new patients
Cleveland Clinic Florida a Nonprofit Corporation Past Accepting new patients
DRS. Hill & Thomas Co. Diagnostic Radiology Past Accepting new patients
DRS. Hill & Thomas Co. Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

1730 W 25th St
Cleveland, OH 44113
Phone (216) 696-4300

12300 McCracken Rd
Garfield Hts, OH 44125
Phone (216) 581-0500

5005 Rockside Rd
Independence, OH 44131
Phone (440) 986-4000

6780 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 331-9520

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

2785 Som Center Rd
Willoughby Hills, OH 44094
Phone (216) 278-0288

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Interoperability endpoints

  • Direct secure messaging: lgrossman32403@direct.ccf.org

Organizations & group practices 11

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 5

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1942230347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # MC28",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-1948",
            "fax_number": "212-305-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # MC28",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-1948",
            "fax_number": "212-305-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "LAURANCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "234320-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02603625",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "W35021",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #",
            "identifier": "02186203",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.