NPIMap

Individual provider Active NPI

Amanda Lynn Gross, MSBS, PA-C

  • Physician Assistant
  • Traverse City, MI
National Provider Identifier
1639633076
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008995 Issued in MI
Practice address
1105 6TH St
Traverse City, MI 49684-2386
Phone
(231) 935-5000
NPI assigned
Jan 30, 2019
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008995 MI Primary

Addresses

Primary practice location

1105 6TH St
Traverse City, MI 49684-2386

Mailing address

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

Other practice location 1

3922 Cedar Run Rd
Traverse City, MI 49684-9687
Phone (231) 392-0430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190306000943 MI Practitioner - Physician Assistant 2163761354 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

1400 Medical Campus Dr
Traverse City, MI 49684-7823
Phone (231) 935-8000

3922 Cedar Run Rd
Bay Area
Traverse City, MI 49684-9687
Phone (231) 935-0322

3930 Cedar Run Rd
Traverse City, MI 49684-9687
Phone (231) 935-0390

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Michigan PLLC CurrentSince Jul 2, 2019 Accepting new patients
Munson Medical Center CurrentSince Mar 1, 2020 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC CurrentSince Jun 9, 2019 Accepting new patients
Pathways Integrative and Lifestyle Medicine PC PastSince May 7, 2023 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

3922 Cedar Run Rd
Traverse City, MI 49684
Phone (231) 392-0430

Organizations & group practices 9

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 4

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": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1639633076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 6TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 6TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842386",
            "telephone_number": "231-935-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3922 Cedar Run Rd",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496849687",
            "country_code": "US",
            "telephone_number": "231-392-0430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSS",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "MSBS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.