Healthcare Provider Details

I. General information

NPI: 1285073916
Provider Name (Legal Business Name): LEONID S GROSSMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2013
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 GOLDEN RIDGE RD STE 250
GOLDEN CO
80401-9541
US

IV. Provider business mailing address

660 GOLDEN RIDGE RD STE 250
GOLDEN CO
80401-9541
US

V. Phone/Fax

Practice location:
  • Phone: 303-233-1223
  • Fax:
Mailing address:
  • Phone: 303-233-1223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036177816
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number62321
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: