| Michael Robert Grossman, DO | |
|
965 Shamrock Ln, Corry, PA 16407-1196 | |
| (814) 664-4641 | |
| (814) 664-8799 |
| Full Name | Michael Robert Grossman |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 35 Years |
| Location | 965 Shamrock Ln, Corry, Pennsylvania |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710929708 | NPI | - | NPPES |
| 204624381C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 051467 (Georgia) | Secondary |
| 207P00000X | Emergency Medicine | OS010419L (Pennsylvania) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Chan Soon- Shiong Medical Center At Windber | Windber, PA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Windber Hospital Inc | 9234187576 | 22 |
| Entity Name | Windber Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1790999837 PECOS PAC ID: 9234187576 Enrollment ID: O20050411000395 |
| Entity Name | Dlp Conemaugh Miners Medical Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629471768 PECOS PAC ID: 2860612439 Enrollment ID: O20141030001653 |
| Entity Name | Nason Physician Practices Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306236609 PECOS PAC ID: 5890012728 Enrollment ID: O20150402000491 |
| Entity Name | Dlp Conemaugh Meyersdale Medical Center, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932500154 PECOS PAC ID: 0446470041 Enrollment ID: O20150427000756 |
| Entity Name | Corry Memorial Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1255788014 PECOS PAC ID: 3971581174 Enrollment ID: O20160816000171 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Robert Grossman, DO 1 Lecom Pl, Erie, PA 16505-2571 Ph: (814) 868-2507 | Michael Robert Grossman, DO 965 Shamrock Ln, Corry, PA 16407-1196 Ph: (814) 664-4641 |
Dr. Michael Antoon, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 612 W Smith St, Corry, PA 16407 Phone: 180-083-4486 | |
Dr. Jonathan L Spaulding, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 965 Shamrock Ln, Corry, PA 16407 Phone: 814-664-4641 Fax: 814-663-9900 |