Individual provider Active NPI

Jonathon Lee Gross, MD, MBA

  • Family Medicine Physician
  • Provo, UT
National Provider Identifier
1750840054
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD493634 Issued in PA
Practice address
395 W Cougar Blvd Ste 205
Provo, UT 84604-3328
Phone
(801) 357-1770
NPI assigned
Mar 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD493634 PA Primary
Family Medicine Physician 207Q00000X 11837381-1205 UT

Addresses

Primary practice location

395 W Cougar Blvd Ste 205
Provo, UT 84604-3328

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 357-1770

Other practice location 1

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (484) 227-4216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR, PA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20221021001672 WA Practitioner - HospitalistPractitioner - Family Practice 5799101085 Reassigns benefits to 2 organizations
I20221024001227 OR Practitioner - Family Practice 5799101085 Reassigns benefits to 3 organizations
I20260428002844 PA Practitioner - Family Practice 5799101085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (610) 566-9400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health Family Medicine Current Accepting new patients
Franciscan Medical Group CurrentSince Feb 17, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 8, 2022 Accepting new patients
Franciscan Medical Group Family Medicine CurrentSince Feb 17, 2025 Accepting new patients
Salem Health Family Medicine CurrentSince Jun 24, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Aug 8, 2022 Accepting new patients
Salem Health West Valley CurrentSince Jun 24, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Aug 8, 2022 Accepting new patients
Salem Health CurrentSince Jun 24, 2024 Accepting new patients
Saint Clare Hospital Past Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

525 SE Washington St
Dallas, OR 97338
Phone (503) 623-7344

10060 NE Evergreen Pkwy
Hillsboro, OR 97124
Phone (503) 645-2762

1601 Monmouth St
Ste 100
Independence, OR 97351
Phone (503) 623-8301

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

890 Oak St SE
Salem, OR 97301
Phone (503) 585-0830

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 11

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.

Hospital & facility affiliations 3

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": "1552694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1750840054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-357-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W COUGAR BLVD STE 205",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043328",
            "telephone_number": "801-357-1770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1068 W Baltimore Pike",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "190635104",
            "country_code": "US",
            "telephone_number": "484-227-4216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSS",
        "first_name": "JONATHON",
        "middle_name": "LEE",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-16",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD493634",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11837381-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.