ARTHUR GROSS JR. DO
NPI 1093374647
Family Medicine in West Reading, PA

Q: What is Arthur Gross's NPI number?

The NPI number for Arthur Gross is 1093374647. It was assigned to this individual provider in the NPPES registry on June 7, 2019.

Q: What is Arthur Gross's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Arthur Gross was last updated on May 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 07, 2019PECOS Enrolled

98.41/100

CMS Quality Rating

420 S 5TH AVE, WEST READING, PA 19611(484) 628-8198(484) 628-8390 Get Directions Write a Review

NPPES record last updated: May 9, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 9, 2022, Jun 7, 2019 (2 updates tracked since 2019).

On this page

About Arthur Gross Jr. Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ARTHUR GROSS JR. DO (NPI 1093374647) is an individual family medicine provider in West Reading, Pennsylvania, licensed in Indiana (02006706A) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093374647

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameARTHUR GROSS JR.Credential: DO

Location Address420 S 5TH AVEWest Reading, PA 19611-2143

Mailing AddressPo Box 13579Reading, PA 19612-3579

Phone(484) 628-8198

Fax(484) 628-8390

Sole ProprietorNo

Enumeration DateJune 7, 2019

Last NPPES UpdateMay 9, 20222 updates tracked since enumeration

NPPES CertifiedMay 9, 2022

✔ NPI 1093374647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in IN · 02006706A✔ Licensed in PA · OT019157

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

420 S 5TH AVE, West Reading, PA 19611

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Arthur Gross Jr. Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Arthur Gross reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

App Of Tennessee Ed, PLLC

539 mi

Emergency Medicine

907 E LAMAR ALEXANDER PKWY
Maryville, TN 37804

Reassigned Medicare billing, Tennessee enrollment
390 clinicians in this Medicare group

NPI 1003230236 (865) 983-7211

Havely Springs Emergency Group, PC

650 mi

Emergency Medicine

100 NORTHCREST DR
Springfield, TN 37172

Reassigned Medicare billing, Tennessee enrollment
22 clinicians in this Medicare group

NPI 1770090110 (615) 698-3000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

159 services145 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

60 services57 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

43 services41 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19611 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.41/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

93.99

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Manual wheelchair accessory, one-arm drive attachment, each E0958

DME-Wheelchairs · category DD021N

1 supplier11 claims11 services$34.31 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TOLUWANIMI OGBONMIDE

Student in an Organized Health Care Education/Training Program

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-8000

URVASHI SARKAR

Student in an Organized Health Care Education/Training Program

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-8000

MADISON HECK

Student in an Organized Health Care Education/Training Program

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-8000

NEIL HOFFMAN M.D.

Pathology (Forensic Pathology)

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-8615

MS. LANE ROSCOE PA- C

Physician Assistant

420 S 5TH AVE
WEST READING, PA 19611

Berks County (610) 568-3637

ALICE LEE DO

Surgery

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-4879

KYLE ROMPALA

Nurse Practitioner (Family)

420 S 5TH AVE
READING, PA 19611

Berks County (267) 280-7615

MATTHEW CRYER

Emergency Medicine

420 S 5TH AVE
WEST READING, PA 19611

Berks County (484) 628-1324

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Arthur Gross's NPI number?

The NPI number for Arthur Gross is 1093374647. It was assigned to this individual provider in the NPPES registry on June 7, 2019.

Where is Arthur Gross located?

Arthur Gross practices at 420 S 5th Ave, West Reading, PA 19611. The listed phone number is (484) 628-8198.

What is Arthur Gross's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Arthur Gross enrolled in Medicare?

Yes. Arthur Gross is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Arthur Gross's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Arthur Gross reassigns Medicare benefits to 2 organizations: App Of Tennessee Ed, PLLC (Maryville, TN) and Havely Springs Emergency Group, PC (Springfield, TN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Arthur Gross's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Arthur Gross accept?

Health plans from Oscar Health and Oscar Insurance Company list Arthur Gross as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Arthur Gross was last updated on May 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.