Individual provider Active NPI

Gary Lance Gross, MD

  • Allergy & Immunology Physician
  • Ocean, NJ
National Provider Identifier
1336143247
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
25MA04805600 Issued in NJ
Practice address
802 W Park Ave
Ste 213
Ocean, NJ 07712-8526
Phone
(732) 695-2555
Fax
(732) 695-2552
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 25MA04805600 NJ Primary
Allergy & Immunology Physician 207K00000X MA048056 NJ

Addresses

Primary practice location

802 W Park Ave
Ste 213
Ocean, NJ 07712-8526

Mailing address

Dept. 453 PO Box 1000
Memphis, TN 38148-0001
Phone (828) 575-2625

Other identifiers 3

IdentifierTypeStateIssuer
3408400MedicaidNJ
029133ZKRPOtherNJMEDICARE PTAN
029133ZVF5OtherNJMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100429000581 NJ Practitioner - Allergy/Immunology 0840327441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
New York University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Partners of NJ PCGroup PAC ID 3274855499, 6 clinicians

Practice addresses (Care Compare)

802 W Park Ave
Suite 213
Ocean, NJ 07712-8526
Phone (732) 695-2555

Hospital & facility affiliations

  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04805600NJMDAllergy & Immunology Physician
MA048056NJMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Partners of NJ, PC Allergy & Immunology CurrentSince Jun 1, 2016 Accepting new patients

Locations

8 Tindall Rd
Middletown, NJ 07748
Phone (732) 671-7676

802 W Park Ave
Ste 213
Ocean, NJ 07712
Phone (732) 631-8976

553 Cedar Ln
Ste A
Teaneck, NJ 07666
Phone (201) 836-6400

504 Hamburg Tpke
Ste B103
Wayne, NJ 07470
Phone (973) 790-6707

Organizations & group practices 1

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 3

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1336143247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. 453 PO BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 W PARK AVE",
            "address_2": "STE 213",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077128526",
            "telephone_number": "732-695-2555",
            "fax_number": "732-695-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "GARY",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "25MA04805600",
            "primary": true
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "MA048056",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408400",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "029133ZKRP",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "029133ZVF5",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean, NJ

Sources for this page

Verify at the official NPI Registry.