Individual provider Active NPI

Jodi Stein Grossfeld, M.D.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1962507707
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
284243 Issued in NY
Practice address
245 E 63Rd St Apt 107
New York, NY 10065-7453
Phone
(212) 980-9292
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 284243 NY Primary

Addresses

Primary practice location

245 E 63Rd St Apt 107
New York, NY 10065-7453

Mailing address

5000 Civic Center Drive
San Rafael, CA 94903
Phone (415) 499-0100

Other identifiers 1

IdentifierTypeStateIssuer
G75125OtherCALICENSE

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
I20160805001527 NY Practitioner - Dermatology 0345289948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Southern California Keck School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cayuga Dermatology, PLLCGroup PAC ID 9638455447, 2 clinicians

Practice addresses (Care Compare)

821 Cliff St
Suite 2
Ithaca, NY 14850-2097
Phone (607) 379-6229

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision30
Removal of skin lesions236
Removal or shaving of skin growth21
Skin biopsy131

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Dermatology, PLLC Dermatology CurrentSince Oct 1, 2023 Accepting new patients
Regents Univ of California UCSF Past Accepting new patients

Locations

821 Cliff St
Ste 2
Ithaca, NY 14850
Phone (607) 351-9822

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1962507707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 CIVIC CENTER DRIVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "94903",
            "telephone_number": "415-499-0100",
            "fax_number": "415-499-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 E 63RD ST APT 107",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657453",
            "telephone_number": "212-980-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSFELD",
        "first_name": "JODI",
        "middle_name": "STEIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "284243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G75125",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.