Keith Mark Gross, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G63544 Issued in CA

Practice address

12550 Hesperia Rd
400
Victorville, CA 92395

Phone

(909) 335-8638

Fax

(909) 335-8644

NPI assigned

May 26, 2006

Last updated

Jun 28, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NV, AZ3 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

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

University of California, Geffen School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Keith Mark Gross MD IncGroup PAC ID 4587712500, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Keith Mark Gross MD Inc

  • Dermatology Physician
  • Victorville, CA
  • NPI 1871658278

  AZ, NV

  Medicare reassignment Care Compare group NPD Authorized official
• Jeffrey Ross Gunter MD Inc

  • Dermatology Physician
  • Lancaster, CA
  • NPI 1053476465

  NV

  Medicare reassignment
• Antelope Valley Health Care District

  • General Acute Care Hospital
  • Lancaster, CA
  • NPI 1366419517
  NPD (past)
• Hospital of Barstow Inc

  dba Barstow Community Hospital

  • General Acute Care Hospital
  • Barstow, CA
  • NPI 1780655670
  NPD (past)
• Osf Medical Group of California, Inc

  dba Spine and Orthopedic Center

  • Orthopaedic Surgery Physician
  • Santa Barbara, CA
  • NPI 1629198742
  NPD (past)
• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  NPD (past)
• Victor Valley Community Hospital

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1952311953
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1952357188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848950",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900848950",
            "telephone_number": "909-335-8638",
            "fax_number": "909-335-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 HESPERIA RD",
            "address_2": "400",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "909-335-8638",
            "fax_number": "909-335-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "KEITH",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NV",
            "license": "7006",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G63544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malia Griffin
• Sara Lynn Griffin, D.C.
• Thereca Griffin, RADTI
• Kharynna Grimes
• Bukola Gross
• Tierra Nichole Grundy, MA
• Ha Bin Gu, PHARMD
• Daisy Guerrero, LVN
• Jordan Anthony Guerrero, CHW
• Laura Guerrero

• Dermatology Physician in Victorville, CA
• Providers in Victorville, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.