Individual provider Active NPI

Robert Stephen Grosserode, MD

  • Ophthalmology Physician
  • Antioch, CA
National Provider Identifier
1982748232
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G51975 Issued in CA
Practice address
3747 Sunset LN
Antioch, CA 94509-6101
Phone
(925) 754-2300
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G51975 CA Primary

Addresses

Primary practice location

3747 Sunset LN
Antioch, CA 94509-6101

Mailing address

3747 Sunset LN
Antioch, CA 94509-6101
Phone (925) 754-2300

Other identifiers 1

IdentifierTypeStateIssuer
00G519750MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080711000556 CA Practitioner - Ophthalmology 6608769633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.87 of 100Reported as group
Quality
93.35
Improvement activities
40
Cost
58.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G51975CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California Eye Clinic Ophthalmology Current Accepting new patients
California Eye Clinic Ophthalmology CurrentSince Apr 30, 1985 Accepting new patients
California Eye Clinic Ophthalmology CurrentSince May 27, 2008 Accepting new patients

Locations

3747 Sunset Ln
#A
Antioch, CA 94509
Phone (925) 754-2300

3747 Sunset Ln
Antioch, CA 94509
Phone (925) 754-2300

1181 Central Blvd
Ste F
Brentwood, CA 94513
Phone (925) 516-0888

2260 Gladstone Dr
Ste 3
Pittsburg, CA 94565
Phone (925) 427-2111

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.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982748232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3747 SUNSET LN",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096101",
            "telephone_number": "925-754-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3747 SUNSET LN",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096101",
            "telephone_number": "925-754-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSERODE",
        "first_name": "ROBERT",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G51975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G519750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.