David Andrew Bross, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

73788 Issued in MA

Practice address

Mystic Valley Pediatrics
75 Riverside Avenue, Suite 2
Medford, MA 02155

Phone

(781) 391-8821

Fax

(781) 395-8798

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1881687804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 APPLETON ST",
            "address_2": "APT #3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021166109",
            "telephone_number": "617-266-5185",
            "fax_number": "781-395-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MYSTIC VALLEY PEDIATRICS",
            "address_2": "75 RIVERSIDE AVENUE, SUITE 2",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "781-391-8821",
            "fax_number": "781-395-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSS",
        "first_name": "DAVID",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "73788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bre Marie Wellness LLC
• Cindy Bridger, PSY.D.
• Brightenhealthgroup
• Chad R Brigockas, LAC
• Nora S Brooke, M.D.
• Leslie Anne Brown-Velazquez, PA-C, MHP
• Holly Brown
• Lorna Brown, PT
• Maren Brown
• Zoe Bryan, LMHC

• Pediatrics Physician in Medford, MA
• Providers in Medford, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.