Monica Sage Gross, M.D,

Individual provider Active NPI Pediatrics Physician · Juneau, AK

NPI 1184789547 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1184789547
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
3322 (AK)
Practice address
1600 Glacier Ave
Juneau, AK 99801-1430
Phone
(907) 586-1542
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/766713c8-6704-4cf2-bcff-6dfc96f148b0/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 3322 AK Yes

Addresses

Primary practice location

1600 Glacier Ave
Juneau, AK 99801-1430

Mailing address

524 Main St
Juneau, AK 99801-1154
Phone (907) 586-6789

Other identifiers

IdentifierTypeStateIssuer
MD14482MedicaidAK

Other providers in Juneau, AK

All providers in Juneau, AK · Pediatrics Physician in Alaska

Sources for this page

Verify at the official NPI Registry.