Individual provider Active NPI

Brian W Gross, M.D.

  • Interventional Cardiology Physician
  • Medford, OR
National Provider Identifier
1194712364
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD1348 Issued in OR
Practice address
520 Medical Center Dr
Ste 200
Medford, OR 97504-4314
Phone
(541) 282-6600
Fax
(541) 282-6601
NPI assigned
Oct 4, 2005
Last updated
Jan 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 13048 OR
Interventional Cardiology Physician 207RI0011X MD1348 OR Primary

Addresses

Primary practice location

520 Medical Center Dr
Ste 200
Medford, OR 97504-4314

Mailing address

520 Medical Center Dr
Ste 200
Medford, OR 97504-4314

Other identifiers 1

IdentifierTypeStateIssuer
263335MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20031219000736 OR Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5193623874 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Rochester School of Medicine and Dentistry, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Oregon Cardiology LLCGroup PAC ID 2264572510, 28 clinicians

Practice addresses (Care Compare)

520 Medical Ctr Dr
Suite 200
Medford, OR 97504-4314
Phone (541) 930-7222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD1348ORMDInterventional Cardiology Physician
13048ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oregon Cardiology LLC Cardiovascular Disease CurrentSince Jan 1, 2010 Accepting new patients
Asante CurrentSince Oct 1, 2002 Accepting new patients
Asante Ashland Community Hospital, LLC CurrentSince May 6, 2018 Accepting new patients
Asante CurrentSince Oct 1, 2002 Accepting new patients
Asante Three Rivers Medical Center, LLC CurrentSince Jan 6, 2010 Accepting new patients

Locations

280 Maple St
Ashland, OR 97520
Phone (541) 201-4000

500 5th St
Brookings, OR 97415
Phone (541) 412-2000

520 SW Ramsey Ave
Ste 204
Grants Pass, OR 97527
Phone (541) 479-8308

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

520 Medical Center Dr
Ste 200
Medford, OR 97504
Phone (541) 282-6600

555 Black Oak Dr
Medford, OR 97504
Phone (541) 734-3434

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Asante Rogue Regional Medical CenterMedford, OR, CCN 380018 Hospital Corporate Director Jan 1, 2020
Asante Rogue Regional Medical CenterMedford, OR, CCN 38S018 Hospital Corporate Director Jan 1, 2020
Asante Rogue Regional Medical CenterMedford, OR, CCN 38T018 Hospital Corporate Director Jan 1, 2020
Asante Ashland Community Hospital LLCAshland, OR, CCN 380005 Hospital Corporate Director Jan 1, 2020
Asante Rogue Regional Medical Center Hospice ServicesTalent, OR, CCN 381527 Hospice Corporate Director Jan 1, 2020

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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

Hospital & facility affiliations 7

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1194712364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR",
            "address_2": "STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR",
            "address_2": "STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044314",
            "telephone_number": "541-282-6600",
            "fax_number": "541-282-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "BRIAN",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "13048",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OR",
            "license": "MD1348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263335",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.