Individual provider Active NPI

William Stephen Gross, MD

  • Vascular Surgery Physician
  • Bloomfield Hills, MI
National Provider Identifier
1043268188
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301036638 Issued in MI
Practice address
4049 Hidden Woods Drive
Bloomfield Hills, MI 48301
Phone
(248) 933-3050
Fax
(248) 562-3229
NPI assigned
May 4, 2006
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 4301036638 MI Primary

Addresses

Primary practice location

4049 Hidden Woods Drive
Bloomfield Hills, MI 48301

Mailing address

4049 Hidden Woods Drive
Bloomfield Hills, MI 48301
Phone (248) 933-3050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160205001702 MI Order and Referring Only - Vascular SurgeryPractitioner - Vascular Surgery 5698858702

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301036638MIMDVascular Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1043268188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4049 HIDDEN WOODS DRIVE",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "48301",
            "telephone_number": "248-933-3050",
            "fax_number": "248-562-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 HIDDEN WOODS DRIVE",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "48301",
            "telephone_number": "248-933-3050",
            "fax_number": "248-562-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "WILLIAM",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301036638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.