Individual provider Active NPI

Debra S Gross, MS,RD,CDE,CDN

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1629368402
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
002364 Issued in NY
Practice address
1879 Madison Ave
New York, NY 10035-2709
Phone
(212) 423-4500
NPI assigned
Apr 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 002364 NY Primary

Addresses

Primary practice location

1879 Madison Ave
New York, NY 10035-2709

Mailing address

1879 Madison Ave
New York, NY 10035-2709
Phone (212) 423-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110614000574 NY Practitioner - Registered Dietitian Or Nutrition Professional 0345427613 Reassigns benefits to 1 organization
I20180108001460 TX Practitioner - Registered Dietitian Or Nutrition Professional 0345427613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Doral Medical and Multi Specialty Facility LLCGroup PAC ID 9830528645, 53 clinicians

Practice addresses (Care Compare)

1797 Pitkin Ave
Suite 2
Brooklyn, NY 11212-7844
Phone (718) 971-1944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Maniilaq Association CurrentSince Nov 29, 2017 Accepting new patients
Doral Medical and Multi Specialty Facility LLC CurrentSince Jun 1, 2025 Accepting new patients
Arctic Slope Native Association LTD Current Accepting new patients
Maniilaq Association Current Accepting new patients
Maniilaq Association CurrentSince Nov 29, 2017 Accepting new patients
Doral Pharmacy LLC PastSince Jun 1, 2025 Accepting new patients

Locations

1797 Pitkin Ave
Ste 2
Brooklyn, NY 11212
Phone (718) 367-2555

1797 Pitkin Ave
Brooklyn, NY 11212
Phone (718) 367-2555

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 6

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": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1629368402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1879 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352709",
            "telephone_number": "212-423-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1879 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352709",
            "telephone_number": "212-423-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "DEBRA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "MS,RD,CDE,CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "002364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.