Individual provider Active NPI

David J Gross, MD

  • Dermatology Physician
  • St Augustine, FL
National Provider Identifier
1346225828
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME62729 Issued in FL
Practice address
1100 S Ponce de Leon Blvd Ste 3B
St Augustine, FL 32084-6013
Phone
(813) 321-1786
Fax
(813) 321-1787
NPI assigned
Dec 7, 2005
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME62729 FL Primary

Addresses

Primary practice location

1100 S Ponce de Leon Blvd Ste 3B
St Augustine, FL 32084-6013

Mailing address

18228 N US Highway 41
Lutz, FL 33549-4400
Phone (813) 321-1786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20081002000055 FL Practitioner - Dermatology 7618045790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
New York Medical College, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suncoast Skin SolutionsGroup PAC ID 7416018221, 102 clinicians

Practice addresses (Care Compare)

1100 S Ponce de Leon Blvd
Suite 3B
St Augustine, FL 32084-6013
Phone (813) 321-1786

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1424
Removal or shaving of skin growth665
Skin biopsy180

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
David J Gross MD PA Dermatology CurrentSince Sep 10, 2008 Accepting new patients
Suncoast Skin Solutions Dermatology CurrentSince Aug 7, 2024 Accepting new patients
Douglas K Pierce MD PA Past Accepting new patients

Locations

18228 N US Highway 41
Lutz, FL 33549

4651 Van Dyke Rd
Lutz, FL 33558
Phone (813) 321-1783

11200 Seminole Blvd
Ste 205
Seminole, FL 33778
Phone (727) 820-1786

1100 S Ponce de Leon Blvd
Ste 3B
St Augustine, FL 32084
Phone (904) 823-9992

Organizations & group practices 3

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 2

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1346225828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18228 N US HIGHWAY 41",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335494400",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD STE 3B",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846013",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME62729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.