Individual provider Active NPI

Diara Satima Gross, D.O.

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Atlanta, GA
National Provider Identifier
1366750168
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
079097 Issued in GA
Practice address
2625 Piedmont Rd NE Ste 56-435
Atlanta, GA 30324-3086
Phone
(678) 749-7020
NPI assigned
Sep 15, 2010
Last updated
Apr 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 079097 GA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 79097 GA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 079097 GA Primary

Addresses

Primary practice location

2625 Piedmont Rd NE Ste 56-435
Atlanta, GA 30324-3086

Mailing address

2625 Piedmont Rd NE Ste 56-435
Atlanta, GA 30324-3086
Phone (678) 749-7020

Other practice location 1

Concentra
900 Ashwood Parkway Suite 130
Atlanta, GA 30354
Phone (404) 531-4197

Other practice location 2

Concentra 6475 Jimmy Carter Blvd
Suite 200
Norcross, GA 30071
Phone (770) 242-7744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20171114002893 GA Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 4789951609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2625 Piedmont Rd NE
Suite 56 435
Atlanta, GA 30324-5906
Phone (678) 749-7020

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79097GAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DG Sports Medicine & Wellness, LLC Sports Medicine CurrentSince Oct 1, 2021 Accepting new patients

Locations

2625 Piedmont Rd NE
Ste 56
Atlanta, GA 30324
Phone (678) 576-4924

2625 Piedmont Rd NE
Ste 56435
Atlanta, GA 30324
Phone (678) 749-7020

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1366750168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 PIEDMONT RD NE STE 56-435",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243086",
            "telephone_number": "678-749-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 PIEDMONT RD NE STE 56-435",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243086",
            "telephone_number": "678-749-7020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Concentra",
            "address_2": "900 Ashwood Parkway Suite 130",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30354",
            "country_code": "US",
            "telephone_number": "404-531-4197",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Concentra 6475 Jimmy Carter Blvd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "30071",
            "country_code": "US",
            "telephone_number": "770-242-7744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSS",
        "first_name": "DIARA",
        "middle_name": "SATIMA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "079097",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "GA",
            "license": "79097",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "GA",
            "license": "079097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.