NPIMap

Individual provider Active NPI

Wayne D Gross, D.O.

  • Cardiovascular Disease Physician
  • Massillon, OH
National Provider Identifier
1013916717
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
34005735 Issued in OH
Practice address
323 Marion Ave NW
Suite 200
Massillon, OH 44646-3639
Phone
(330) 837-1111
Fax
(330) 837-1769
NPI assigned
Jul 15, 2005
Last updated
Jun 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 34005735 OH Primary

Addresses

Primary practice location

323 Marion Ave NW
Suite 200
Massillon, OH 44646-3639

Mailing address

323 Marion Ave NW
Suite 200
Massillon, OH 44646-3639
Phone (330) 837-1111

Other identifiers 1

IdentifierTypeStateIssuer
0925280MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051028000379 OH Practitioner - Cardiovascular Disease (Cardiology) 6608853320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Oklahoma State University College of Osteopathic Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Physician Services LLCGroup PAC ID 0143366591, 97 clinicians

Practice addresses (Care Compare)

515 Union Ave
Suite 167
Dover, OH 44622-3005
Phone (330) 343-3335

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
The Union Hospital Association CurrentSince Oct 15, 2001 Accepting new patients
Union Physician Services, LLC CurrentSince Nov 26, 2019 Accepting new patients
RC Hastedt MD Inc Current Accepting new patients
Community Pathologists Inc Current Accepting new patients
The Union Hospital Association CurrentSince Oct 15, 2001 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

205 Hospital Dr
Dover, OH 44622
Phone (330) 343-3335

515 Union Ave
Ste 167
Dover, OH 44622
Phone (330) 343-3335

659 Boulevard St
Dover, OH 44622
Phone (330) 343-3311

323 Marion Ave NW
Ste 200
Massillon, OH 44646
Phone (330) 837-1111

Interoperability endpoints

  • Direct secure messaging: wgross1407041@direct.ccf.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1013916717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 MARION AVE NW",
            "address_2": "SUITE 200",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446463639",
            "telephone_number": "330-837-1111",
            "fax_number": "330-837-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 MARION AVE NW",
            "address_2": "SUITE 200",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446463639",
            "telephone_number": "330-837-1111",
            "fax_number": "330-837-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "WAYNE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "34005735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0925280",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

Verify at the official NPI Registry.