Active NPI
Melvyn Gross, MD
- Pediatrics Physician
- Oceanside, NY
National Provider Identifier
1679230528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 162860
- Practice address
- 175 Bennett St
Oceanside, NY 11572-5501 - Phone
- (516) 231-0759
- NPI assigned
- Nov 25, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 162860 | NY | Primary |
Addresses
Primary practice location
175 Bennett St
Oceanside, NY 11572-5501
Mailing address
175 Bennett St
Oceanside, NY 11572-5501
Phone (516) 231-0759
Other practice location 1
3 Hakablan Street
Jerusalem, Israel 93874
IL
Phone (516) 231-0759
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 162860 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637798400000",
"number": "1679230528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 BENNETT ST",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115725501",
"telephone_number": "516-231-0759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 BENNETT ST",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115725501",
"telephone_number": "516-231-0759"
}
],
"practiceLocations": [
{
"address_1": "3 Hakablan Street",
"address_purpose": "LOCATION",
"city": "Jerusalem",
"state": "Israel",
"postal_code": "93874",
"country_code": "IL",
"telephone_number": "516-231-0759",
"country_name": "Israel",
"address_type": "FGN"
}
],
"basic": {
"last_name": "GROSS",
"first_name": "MELVYN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-25",
"last_updated": "2021-11-25",
"certification_date": "2021-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "162860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oceanside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.