DR. MICHAEL SAMUEL GROSSMAN (NPI# 1215016662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215016662 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL SAMUEL GROSSMAN |
| Credential | M.D. |
| Practice Address |
4505 N Rockwood Dr Peoria IL 61615-3803 |
| Mailing Address |
3602 Marquette Rd Peru IL 61354-1450 |
| Practice Telephone | 3095891880 |
| Mailing Telephone | 8152237400 |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2017-01-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 036128242 | IL | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | 202629 | LA | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 29207 | SC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407217540 | Michael Grossman | Chiropractor | 425 Washington St Ste 100, San Francisco, CA 94111-2345 | 2016-03-17 |
| 1417055286 | Michael Alan Grossman | Dentist | 6246 East Pima Street, Suite 100, Tucson, AZ 85712-3157 | 2006-09-20 |
| 1659488997 | Michael Grossman | Internal Medicine | 550 E Van Buren St, Building 3, Room 3261, Phoenix, AZ 85004-2230 | 2006-08-24 |
| 1225011786 | Michael R. Grossman | Podiatrist | 121 Coulter Ave, Suite 109, Ardmore, PA 19003-2418 | 2005-11-29 |
| 1831188218 | Michael J Grossman | Obstetrics & Gynecology | 565 Turnpike St, Suite 74, North Andover, MA 01845-5922 | 2005-10-18 |
| 1245239102 | Michael Grossman | Emergency Medicine | 4505 20th Ave, Valley, AL 36854-3542 | 2005-07-21 |
| 1467455816 | Michael Paul Grossman | Obstetrics & Gynecology | 38a Old Sparrowbush Road, Latham, NY 12110 | 2005-05-31 |
| 1760810857 | Michael Grossman | Nurse Practitioner | 960 Johnson Ferry Rd, Ste 500, Atlanta, GA 30342-1631 | 2013-10-29 |
| 1942367008 | Michael Jack Grossman | Family Medicine | 24432 Muirlands Blvd, Suite 111, Lake Forest, CA 92630-3939 | 2007-01-01 |
| 1265594758 | Michael S Grossman | Specialist | 901 Lakeshore Drive, Ishpeming, MI 49849 | 2006-12-14 |
| Street Address |
4505 N ROCKWOOD DR |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-3803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609297936 | Srinivas Jujjavarapu Md LLC | Internal Medicine | 4505 N Rockwood Dr, Peoria, IL 61615-3803 | 2014-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982899258 | Parminderpal Singh | Ophthalmology | 9151 W Thunderbird Rd Ste G101, Peoria, AZ 85381-4906 | 2007-09-10 |
| 1629294285 | Peoria Area Vision Care, LLC | Ophthalmology | 8921 North Wood Sage Rd, Peoria, IL 61615-7822 | 2007-04-18 |
| 1689769143 | Southwest Eye Surgeons, Ltd | Ophthalmology | 9151 W Thunderbird Rd # G101, Peoria, AZ 85381-4906 | 2006-10-03 |
| 1295833192 | Min Cheol Kim | Ophthalmology | 14155 North 83rd Avenue, Suite 1103, Peoria, AZ 85381 | 2006-09-21 |
| 1679593123 | Wyman Sicher Eye Associates Sc | Ophthalmology | 8921 N. Wood Sage Rd, Peoria, IL 61615 | 2006-07-20 |
| 1992737084 | Chittaranjan Venkat Reddy | Ophthalmology | 3310 W Chartwell Rd, Suite 101, Peoria, IL 61614 | 2006-07-07 |
| 1689601940 | Retina Consultants of Central Illinois, Sc | Ophthalmology | 3310 West Chartwell Road, Suite 101, Peoria, IL 61614 | 2006-06-26 |
| 1215995949 | Plaza Del Rio Eye Clinic, PC | Ophthalmology | 13340 N 94th Dr, Peoria, AZ 85381-4236 | 2006-05-02 |
| 1558349001 | Martha Joanne Willi | Ophthalmology | 1216 N Maplewood Ave, Peoria, IL 61606-1038 | 2006-01-05 |
| 1366424756 | Peoria Eye Clinic, Ltd | Ophthalmology | 2422 W Nebraska Ave, Peoria, IL 61604-3112 | 2005-11-19 |
| Find all providers in PEORIA | ||||
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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.