Individual provider Active NPI

James R Gross, M.D.

  • Otolaryngology Physician
  • Mount Vernon, WA
National Provider Identifier
1023082203
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD00019697 Issued in WA
Practice address
118 S 12TH St
Mount Vernon, WA 98274-4036
Phone
(360) 336-2178
Fax
(360) 336-1995
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X MD00019697 WA
Otolaryngic Allergy Physician 207YX0602X MD00019697 WA
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X MD00019697 WA
Plastic Surgery Physician 208200000X MD00019697 WA
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X MD00019697 WA
Surgery Physician 208600000X MD00019697 WA
Plastic and Reconstructive Surgery Physician 2086S0122X MD00019697 WA
Surgical Oncology Physician 2086X0206X MD00019697 WA
Otolaryngology Physician 207Y00000X MD00019697 WA Primary

Addresses

Primary practice location

118 S 12TH St
Mount Vernon, WA 98274-4036

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgross12462@skagit.direct-ci.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100907000830 WA Practitioner - OtolaryngologyPractitioner - Allergy/ImmunologyPractitioner - Plastic and Reconstructive SurgeryPractitioner - Surgical Oncology 5092839415 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology, Plastic and Reconstructive Surgery, Surgical Oncology
Education
University of Washington School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

118 S 12TH St
Mount Vernon, WA 98274-4036
Phone (360) 336-2178

Hospital & facility affiliations

  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Jul 27, 2020 Accepting new patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jan 1, 2014 Accepting new patients
Proliance Surgeons, Inc., P.S. Otolaryngology CurrentSince Jan 1, 2014 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Jul 27, 2020 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

1019 24th St
#B
Anacortes, WA 98221
Phone (360) 293-8438

118 S 12th St
Mount Vernon, WA 98274
Phone (360) 336-2178

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

111 S 13th St
Mount Vernon, WA 98274
Phone (360) 336-2178

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: jgross12462@skagit.direct-ci.com

Organizations & group practices 7

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

Hospital & facility affiliations 1

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1023082203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "fax_number": "360-336-1674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S 12TH ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744036",
            "telephone_number": "360-336-2178",
            "fax_number": "360-336-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "JAMES",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "WA",
            "license": "MD00019697",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "WA",
            "license": "MD00019697",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "WA",
            "license": "MD00019697",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WA",
            "license": "MD00019697",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "WA",
            "license": "MD00019697",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00019697",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD00019697",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "WA",
            "license": "MD00019697",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00019697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgross12462@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "118 S 12th St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.