Individual provider Active NPI

Sonya Gross

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1235871997
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MA063471 Issued in PA
Practice address
3401 N Broad St Ste 410
Philadelphia, PA 19140-5103
Phone
(865) 441-6784
NPI assigned
Apr 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MA063471 PA Primary

Addresses

Primary practice location

3401 N Broad St Ste 410
Philadelphia, PA 19140-5103

Mailing address

316 W Providence Rd
Aldan, PA 19018-3830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230216000993 PA Practitioner - Physician Assistant 8123490398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA063471PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Nov 4, 2022 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Nov 4, 2022 Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients

Locations

2365 Heritage Center Dr
Furlong, PA 18925
Phone (215) 728-3883

2701 DeKalb Pike
Norristown, PA 19401
Phone (215) 335-6000

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

8815 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8145

3401 N Broad St
Ste 410
Philadelphia, PA 19140
Phone (215) 539-0021

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

Organizations & group practices 4

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": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1235871997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W PROVIDENCE RD",
            "city": "ALDAN",
            "state": "PA",
            "postal_code": "190183830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST STE 410",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "865-441-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "SONYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MA063471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.