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DR. JAY S GROSSMAN DDS
NPI 1144354713
Dentist - General Practice in Los Angeles, CA

Active since March 15, 2007Opted out of Medicare · through Mar 29, 2028
11980 SAN VICENTE BLVD STE 507, LOS ANGELES, CA 90049(310) 820-0123(310) 207-3784 Get Directions Write a Review

NPPES record last updated: March 14, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Jay S Grossman Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAY S GROSSMAN DDS (NPI 1144354713) is an individual general practice provider in Los Angeles, California, licensed in California (38686) and active in the NPI registry since March 2007. He has opted out of Medicare through March 29, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1144354713
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. JAY S GROSSMANCredential: DDS
Location Address11980 SAN VICENTE BLVD STE 507Los Angeles, CA 90049-6603
Mailing Address11980 San Vicente Blvd Ste 507Los Angeles, CA 90049-6603 · (310) 820-0123 · Fax (310) 207-3784
Phone(310) 820-0123
Fax(310) 207-3784
Sole ProprietorYes
Enumeration DateMarch 15, 2007
Last NPPES UpdateMarch 14, 2018
✔ NPI 1144354713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 38686
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
11980 SAN VICENTE BLVD STE 507, Los Angeles, CA 90049
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jay S Grossman Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 29, 2018 through March 29, 2028.

Opt-Out Effective DateMarch 29, 2018
Opt-Out In Effect ThroughMarch 29, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90049 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR JAY GROSSMAN & ASSOCIATES
Dentist (General Practice)
11980 SAN VICENTE BLVD STE 507
LOS ANGELES, CA 90049
Los Angeles County (310) 820-0123

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jay Grossman's NPI number?

The NPI number for Jay Grossman is 1144354713. It was assigned to this individual provider in the NPPES registry on March 15, 2007.

Where is Jay Grossman located?

Jay Grossman practices at 11980 San Vicente Blvd Ste 507, Los Angeles, CA 90049. The listed phone number is (310) 820-0123.

What is Jay Grossman's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Jay Grossman enrolled in Medicare?

No. Jay Grossman has opted out of Medicare through March 29, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jay Grossman was last updated on March 14, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.