DR. PHILIP JAMES GROSS OD
NPI 1295771939
Optometrist in Dover, DE
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
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Philip Gross reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Wilmington, DE 19808
- Reassigned Medicare billing, Delaware enrollment
- 45 clinicians in this Medicare group
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 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.
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.
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.
Reported Quality Measures
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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.
Which organization bills Medicare for Philip Gross's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Philip Gross reassigns Medicare benefits to Simon Eye Associates PA (Wilmington, DE). The 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 Philip Gross's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Philip Gross accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Highmark Blue Cross Blue Shield Delaware and 1 other insurer 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.
# Dr. Philip James Gross, OD · NPI 1295771939
Optometrist provider in Dover, Delaware. Individual provider, active in the CMS NPPES registry since June 21, 2006.
## Identity
- **NPI:** 1295771939 (Entity type: Individual)
- **Enumerated:** June 21, 2006
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** I30001248 (Delaware)
- **Sole proprietor:** No
## Practice location
- **Address:** 820 WALKER ROAD, Dover, DE 19904
- **Phone:** (302) 678-3545 · **Fax:** (302) 734-3115
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Simon Eye Associates PA (NPI 1205871506, Wilmington, DE), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Pennsylvania College Of Optometry, class of 1991
## Record status
- **NPPES last updated:** February 2, 2010
- **Other identifiers:** Medicare UPIN U29050 (DE); Medicare PIN 00A563V64 (DE)
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Source: [NPI Profile](https://npiprofile.com/npi/1295771939) · Data from the CMS NPPES public registry.