Individual provider Active NPI

Jordana N Gross, MD

  • Pediatrics Physician
  • Brookhaven, GA
National Provider Identifier
1760131387
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
111224 Issued in GA
Practice address
1575 Northeast Expy NE
Brookhaven, GA 30329-2317
Phone
(404) 785-2198
Fax
(404) 785-9168
NPI assigned
Mar 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 111224 GA Primary

Addresses

Primary practice location

1575 Northeast Expy NE
Brookhaven, GA 30329-2317

Mailing address

1575 Northeast Expy NE
Brookhaven, GA 30329-2317
Phone (404) 785-2198

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jordana.gross.1@1823.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251003001816 NY Practitioner - Pediatric Medicine 5991201352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
New York Medical College, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9 Carey Rd
Queensbury, NY 12804-7880

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
335822NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Headwaters Health Network Pediatrics CurrentSince Sep 29, 2025 Accepting new patients
Hudson Headwaters Health Network Pediatrics CurrentSince Sep 29, 2025 Accepting new patients
Hudson Headwaters Health Network Past Accepting new patients

Locations

828 State Route 11
Champlain, NY 12919
Phone (518) 298-2691

9 Carey Rd
Queensbury, NY 12804

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": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1760131387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 NORTHEAST EXPY NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292317",
            "telephone_number": "404-785-2198",
            "fax_number": "404-785-9168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 NORTHEAST EXPY NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292317",
            "telephone_number": "404-785-2198",
            "fax_number": "404-785-9168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "JORDANA",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "111224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jordana.gross.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "828 State Route 11",
            "city": "Champlain",
            "state": "NY",
            "country_code": "US",
            "postal_code": "129194966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

Verify at the official NPI Registry.