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DR. PHILIP JAMES GROSS OD
NPI 1295771939
Optometrist in Dover, DE

Active since June 21, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
820 WALKER ROAD, DOVER, DE 19904(302) 678-3545(302) 734-3115 Get Directions Write a Review

NPPES record last updated: February 2, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Philip James Gross Od NPPES

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

DR. PHILIP JAMES GROSS OD (NPI 1295771939) is an individual optometrist in Dover, Delaware, licensed in Delaware (I30001248) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of Pennsylvania College Of Optometry (1991).

NPPES Registry Identity

NPI1295771939
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. PHILIP JAMES GROSSCredential: OD
Location Address820 WALKER ROADDover, DE 19904
Mailing Address820 Walker RoadDover, DE 19904 · (302) 678-3545 · Fax (302) 734-3115
Phone(302) 678-3545
Fax(302) 734-3115
Sole ProprietorNo
Medical School CMSPennsylvania College Of OptometryGraduated 1991
Enumeration DateJune 21, 2006
Last NPPES UpdateFebruary 2, 2010
✔ NPI 1295771939 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in DE · I30001248
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
820 WALKER ROAD, Dover, DE 19904
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Other Identifiers 2

Medicare UPINU29050DE
Medicare PIN00A563V64DE

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Philip James Gross Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608901772
PECOS Enrollment IDI20100315000261
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.

Areas of Expertise CMS Part B claims 8

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.

Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
447 services304 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
354 services231 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
345 services342 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
340 services249 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
335 services271 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
76 services74 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19904 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
$131.15 typical visit price
range $57.12 – $173.08
Typical copayment $32.78 (range $14.28 – $43.27)
Most-billed visit code 99204
Established Patient
$71.19 typical visit price
range $18.36 – $141.05
Typical copayment $17.79 (range $4.59 – $35.26)
Most-billed visit code 99213
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care
100%158 patients
Provide Patients Electronic Access to Their Health Information
100%2,266 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

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

DR. MICHELE RENEE HARANIN OD
Optometrist
820 WALKER ROAD
DOVER, DE 19904
Kent County (302) 678-3545

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 Philip Gross's NPI number?

The NPI number for Philip Gross is 1295771939. It was assigned to this individual provider in the NPPES registry on June 21, 2006.

Where is Philip Gross located?

Philip Gross practices at 820 Walker Road, Dover, DE 19904. The listed phone number is (302) 678-3545.

What is Philip Gross's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Philip Gross enrolled in Medicare?

Yes. Philip Gross is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Philip Gross accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Highmark Blue Cross Blue Shield Delaware and Providence Health Plan list Philip 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 Philip Gross was last updated on February 2, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.