Individual provider Active NPI

Erica Lynne Gross, O.D.

  • Optometrist
  • Seattle, WA
National Provider Identifier
1174776124
Registry record updated Nov 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60048711 Issued in WA
Practice address
4401 4TH Ave S
Seattle, WA 98134-2311
Phone
(206) 464-7916
NPI assigned
Nov 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60048711 WA Primary

Addresses

Primary practice location

4401 4TH Ave S
Seattle, WA 98134-2311

Mailing address

912 197TH Ave SE
Sammamish, WA 98075-8610
Phone (425) 968-5204

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

State licenses

LicenseStateTypeSpecialty
2120CTMDChiropractor
60048711WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Wong & Associates, LTD. Optometrist PastSince Oct 1, 2003 Accepting new patients
S H Laufer of Port Chester Inc Optometrist PastSince Jul 16, 2016 Accepting new patients

Organizations & group practices 2

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": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1174776124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 197TH AVE SE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980758610",
            "telephone_number": "425-968-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 4TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981342311",
            "telephone_number": "206-464-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "ERICA",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-03",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60048711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; 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.