Andrea Grace Gross, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5230 Issued in OK

Practice address

1120 S Utica Ave
Tulsa, OK 74104-4090

Phone

(918) 579-7100

NPI assigned

Jul 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mattyg LLC

  • Physical Therapist
  • Tulsa, OK
  • NPI 1750735734
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1770136954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044090",
            "telephone_number": "918-579-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044090",
            "telephone_number": "918-579-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3202 S Memorial Dr Ste 9",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741451323",
            "country_code": "US",
            "telephone_number": "918-280-0180",
            "fax_number": "918-280-0170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSS",
        "first_name": "ANDREA",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15057148",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stanley E. Grogg, DO
• Nicholas Ryan Groom, LPN
• Stanley Stuart Groom, DDS
• Harley Grooms
• Shatoya D Grooms
• Angel Gross
• Naina L Gross, MD
• Nicole Mary Gross
• Nicole R. Gross
• Jennifer Grosso, BS

• Physical Therapist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.