Individual provider Active NPI

Seymour Z Gross, PH.D.

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1164572038
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP1653 Issued in MN
Practice address
1801 Nicollet Ave
Minneapolis, MN 55403-3793
Phone
(612) 596-0838
Fax
(612) 879-3823
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP1653 MN Primary

Addresses

Primary practice location

1801 Nicollet Ave
Minneapolis, MN 55403-3793

Mailing address

1941 Drew Ave S
Minneapolis, MN 55416-3617
Phone (612) 926-5961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin County Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1164572038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 DREW AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554163617",
            "telephone_number": "612-926-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033793",
            "telephone_number": "612-596-0838",
            "fax_number": "612-879-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "SEYMOUR",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP1653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.