Marisa E. Gross, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301101278 Issued in MI

Practice address

17500 SE 392ND St
Auburn, WA 98092-9705

Phone

(253) 294-8201

Fax

(253) 333-3612

NPI assigned

Jul 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, TX2 enrollments

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 2

Specialty

Family Practice

Education

University of Michigan Medical School, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Muckleshoot Indian TribeGroup PAC ID 5092724286, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgross@sagchip.directbygreenway.com

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.

• Muckleshoot Indian Tribe

  • Clinic/Center
  • Auburn, WA
  • NPI 1558448175

  TX

  Medicare reassignment Care Compare group NPD
• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1730136367

  Family Medicine

  Medicare reassignment NPD
• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1023830346
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1376807503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 194TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364604",
            "telephone_number": "425-835-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 SE 392ND ST",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980929705",
            "telephone_number": "253-294-8201",
            "fax_number": "253-333-3612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4111 194th St SW",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980364604",
            "country_code": "US",
            "telephone_number": "425-835-5209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2591 S Leaton Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "MI",
            "postal_code": "488588421",
            "country_code": "US",
            "telephone_number": "899-775-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSS",
        "first_name": "MARISA",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301101278",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301101278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasvir Grewal, OWNER
• Griffen LLC
• Paula Dawn Griffin, MA, RC
• Marta Jo Grissom, LMHC
• Jason Matthew Groepper, M.S.
• Scott Gross
• Gina Dannielle Grosso, MS, CCC-SLP
• Stanley Alan Gruber, RN
• Marley R Guajardo, MSW, LSWAIC, MHP
• Guardian Medical Transportation LLC

• Family Medicine Physician in Auburn, WA
• Providers in Auburn, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.