JACK GROSSMAN DO
NPI 1255076410
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Q: What is Jack Grossman's NPI number?

The NPI number for Jack Grossman is 1255076410. It was assigned to this individual provider in the NPPES registry on May 2, 2022.

Q: What is Jack Grossman's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Grossman was last updated on July 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 02, 2022

801 OSTRUM ST, BETHLEHEM, PHILADELPHIA, PA 18015(484) 526-4000(866) 691-7505 Get Directions Write a Review

NPPES record last updated: July 3, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 3, 2023, May 2, 2022 (2 updates tracked since 2022).

On this page

About Jack Grossman Do NPPES

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

JACK GROSSMAN DO (NPI 1255076410) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania and active in the NPI registry since May 2022.

NPPES Registry Identity

NPI1255076410

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACK GROSSMANCredential: DO

Location Address801 OSTRUM ST, BETHLEHEMPhiladelphia, PA 18015

Mailing Address801 Ostrum StBethlehem, PA 18015-1000 · (484) 526-4000 · Fax (866) 691-7505

Phone(484) 526-4000

Fax(866) 691-7505

Sole ProprietorNo

Enumeration DateMay 2, 2022

Last NPPES UpdateJuly 3, 20232 updates tracked since enumeration

NPPES CertifiedJune 21, 2023

✔ NPI 1255076410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedSurgeryTaxonomy 208600000X · License OT022084 (PA)

801 OSTRUM ST, Philadelphia, PA 18015

Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

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

DR. MELANIE KAY TUROCK D.O.

Emergency Medicine

801 OSTRUM ST, DEPT. OF EMERGENCY MEDICINE
BETHLEHEM, PA 18015

Northampton County (610) 954-4903

KELLY HAY

Emergency Medicine