NEIL J GROSSMAN (NPI# 1770527715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770527715 |
| Entity Type | Individual |
| Full Name | NEIL J GROSSMAN |
| Credential | MD |
| Practice Address |
55 Lake Ave N Department of Pediatrics Worcester MA 01655-0002 |
| Mailing Address |
Po Box 415348 Boston MA 02241-5348 |
| Practice Telephone | 7744418083 |
| Practice Fax Number | 7744418057 |
| Mailing Telephone | 8002258885 |
| Mailing Fax Number | 5083341977 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
238502 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110081553A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629086814 | Neil Steven Grossman | Dentist | 125 Madison Ave, Mount Holly, NJ 08060-2039 | 2006-08-03 |
| 1710917059 | Neil S. Grossman | Psychologist | 7 Debbie Ct, Dix Hills, NY 11746-5601 | 2006-07-03 |
| 1649662016 | Neil Grossman | Pharmacist | 54 East St, Ludlow, MA 01056-3407 | 2015-02-23 |
| 1013109032 | Neil Scott Grossman | Physician Assistant | 35 E 35th St, Suite 202, New York, NY 10016-3823 | 2007-08-14 |
| 1568414977 | Neil Grossman | Radiology | 366 Washington St, Wellesley, MA 02481-6206 | 2006-05-16 |
| Street Address |
55 LAKE AVE N DEPARTMENT OF PEDIATRICS |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306057401 | Stefanie Rose Lowas | Pediatrics | 55 Lake Ave N, Worcester, MA 01655-0002 | 2007-05-24 |
| 1205810330 | Peter E Newburger | Pediatrics | 55 Lake Ave N, Worcester, MA 01655-0002 | 2005-12-01 |
| 1144202565 | Christopher P Keuker | Pediatrics | 55 Lake Ave N, Department of Pediatric Hematology/oncology, Worcester, MA 01655-0002 | 2005-11-20 |
| 1184613598 | Ghazala Naheed Usmani | Pediatrics | 55 Lake Ave N, Worcester, MA 01655-0002 | 2005-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558788869 | John Prensner | Pediatrics | 44 Binney St Bldg Floor3, Boston, MA 02115-6013 | 2014-03-25 |
| 1649556879 | Yasser Elborai | Pediatrics | 450 Brookline Ave # Sw301, Boston, MA 02215-5418 | 2011-11-02 |
| 1013242296 | Kaveri Suryanarayan | Pediatrics | 20 Blueberry Ln, Westwood, MA 02090-3002 | 2009-10-06 |
| 1306026919 | Patrick Francis Kelly | Pediatrics | 87 Cambridgepark Dr, Y2010, Cambridge, MA 02140-2311 | 2007-11-12 |
| 1386834422 | Sonia Franco | Pediatrics | 1 Blackfan Cir, Karp Rbo9006f, Boston, MA 02115-5713 | 2007-07-25 |
| 1841354941 | Todd R Golub | Pediatrics | Dana-farber Cancer Inst, 44 Binney Street, Boston, MA 02115 | 2006-12-21 |
| 1063574093 | Ilonna J Rimm | Pediatrics | Expertise for Innovation Consulting, 11 Broken Tree Rd., Newton Center, MA 02459 | 2006-12-15 |
| 1184702722 | Daniel P. Kronish | Pediatrics | 66 Revere St, Boston, MA 02114-4405 | 2006-11-01 |
| 1992766984 | Jennifer S Whangbo | Pediatrics | 44 Binney Street, Dana 3, Dana Farber Cancer Institute, Boston, MA 02115 | 2006-03-29 |
| 1902874241 | Kapil Saxena | Pediatrics | 300 Longwood Ave # Fegan707, Children's Hospital Boston, Boston, MA 02115-5724 | 2006-03-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.