NPIMap

Individual provider Active NPI

Russell A Gross, MD

  • Internal Medicine Physician
  • Middletown, NJ
National Provider Identifier
1255305686
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA03612600 Issued in NJ
Practice address
1270 Highway 35
Middletown, NJ 07748-2014
Phone
(732) 615-3900
Fax
(732) 615-0865
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA03612600 NJ Primary

Addresses

Primary practice location

1270 Highway 35
Middletown, NJ 07748-2014

Mailing address

PO Box 8000
Dept 596
Buffalo, NY 14267-0002
Phone (732) 615-3900

Other identifiers 2

IdentifierTypeStateIssuer
1686402MedicaidNJ
200993DE4OtherNJMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080305000559 NJ Practitioner - Internal Medicine 2961587696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rwjbh Primary Care ServicesGroup PAC ID 0749699346, 266 clinicians

Practice addresses (Care Compare)

766 Shrewsbury Ave
Suite 100
Tinton Falls, NJ 07724-3001
Phone (732) 945-2009

Hospital & facility affiliations

  • Visiting Nurse Association of Central Jersey Home Care and Hospice Home health agency, Toms River, NJ, CCN 317067
  • Hackensack Meridian at Home Monmouth County Home health agency, Neptune, NJ, CCN 317084
  • Riverview Medical Center Hospital, Red Bank, NJ, CCN 310034
  • Bayshore Medical Center Hospital, Holmdel, NJ, CCN 310112
  • Monmouth Medical Center Hospital, Long Branch, NJ, CCN 310075
  • Centrastate Medical Center Hospital, Freehold, NJ, CCN 310111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Primary Care Services Internal Medicine CurrentSince Oct 2, 2021 Accepting new patients
Medical Health Center, P.a. Internal Medicine Past Accepting new patients
Colts Neck OBGYN Associates, LLC Past Accepting new patients
Kenneth Faistl, MD,PA PastSince Mar 13, 2009 Accepting new patients

Locations

166 Lyons Ave
Newark, NJ 07112
Phone (973) 926-7300

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

766 Shrewsbury Ave
Ste 100
Tinton Falls, NJ 07724
Phone (732) 945-2009

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

Interoperability endpoints

  • Direct secure messaging: rgross45942@epicdirect.rwjbh.org

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.

Hospital & facility affiliations 8

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1255305686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8000",
            "address_2": "DEPT 596",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142670002",
            "telephone_number": "732-615-3900",
            "fax_number": "732-615-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 HIGHWAY 35",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482014",
            "telephone_number": "732-615-3900",
            "fax_number": "732-615-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "RUSSELL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03612600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1686402",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "200993DE4",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NJ

Sources for this page

Verify at the official NPI Registry.