Individual provider Active NPI

Gary Gross, MD

  • Obstetrics & Gynecology Physician
  • Davis, CA
National Provider Identifier
1508921784
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
32510 Issued in MA
Practice address
1550 Drew Ave
Ste 100
Davis, CA 95618-1628
Phone
(530) 771-0177
Fax
(530) 771-0135
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 32510 MA Primary

Addresses

Primary practice location

1550 Drew Ave
Ste 100
Davis, CA 95618-1628

Mailing address

1550 Drew Ave
Ste 100
Davis, CA 95618-1628
Phone (530) 771-0177

Other identifiers 6

IdentifierTypeStateIssuer
0235816OtherMACIGNA
0709026OtherMAUNITED HEALTH CARE
D32621OtherMAHARVARD PILGRIM
4294344OtherMAAETNA
700800OtherMATUFTS HEALTH PLAN
M07809OtherMABCBS OF MA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32510MAMDObstetrics & Gynecology Physician
17962CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Ivf Fertility Center Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Marino Foundation for Integrative Medicine, Inc. Obstetrics & Gynecology Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1508921784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 DREW AVE",
            "address_2": "STE 100",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956181628",
            "telephone_number": "530-771-0177",
            "fax_number": "530-771-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 DREW AVE",
            "address_2": "STE 100",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956181628",
            "telephone_number": "530-771-0177",
            "fax_number": "530-771-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "GARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "32510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0235816",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0709026",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "D32621",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4294344",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "700800",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MA",
            "identifier": "M07809",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.