Edward John Gross, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0074351 Issued in FL

Practice address

1035 Primera Blvd.
Lake Mary, FL 32746-2193

Phone

(407) 333-3040

Fax

(407) 333-3496

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Dr. Edward John Gross Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Edward J. Gross M.D., PL

  • Plastic and Reconstructive Surgery Physician
  • Lake Mary, FL
  • NPI 1609948330
  NPD (past) Authorized official
• Heartland ENT & Allergy Center, P.S.C.

  • Otolaryngology Physician
  • Elizabethtown, KY
  • NPI 1780763078
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1912929043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PRIMERA BLVD.",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462193",
            "telephone_number": "407-333-3040",
            "fax_number": "407-333-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PRIMERA BLVD.",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462193",
            "telephone_number": "407-333-3040",
            "fax_number": "407-333-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "EDWARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0074351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2371491",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "593613914",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECH STREET",
            "identifier": "593613914",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4856086004",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1000573",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "46407",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDWARD",
            "last_name": "GROSS",
            "middle_name": "JOHN",
            "prefix": "DR.",
            "credential": ".M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Andrew Griffiths
• Zulma Grijalba, RMHCI
• Amber Grimm, PA-C
• Challis Amanda Beven Grimm, ARNP
• Michael Harris Grocholski, D.C.
• Sharon Lee Gross, PT
• Annika Lou Gudel
• Larissa Antonia Guerrero, MD
• Kayla Elizabeth Guevara
• Varunee W Gumpangkum, PHYSICAL THERAPIST

• Specialist in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.