THEODORE GROSS
NPI 1922531508
Pediatrics in Fruitland, ID

Q: What is Theodore Gross's NPI number?

The NPI number for Theodore Gross is 1922531508. It was assigned to this individual provider in the NPPES registry on April 10, 2017.

Q: What is Theodore Gross's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Theodore Gross was last updated on August 5, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 10, 2017PECOS Enrolled

1100 NW 12TH ST, FRUITLAND, ID 83619(208) 452-6556 Get Directions Write a Review

NPPES record last updated: August 5, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 5, 2025, Jul 20, 2021, Apr 10, 2017 (3 updates tracked since 2017).

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About Theodore Gross NPPES

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

THEODORE GROSS (NPI 1922531508) is an individual pediatrics provider in Fruitland, Idaho, licensed in Idaho (M-15894) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1922531508

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameTHEODORE GROSS

Location Address1100 NW 12TH STFruitland, ID 83619-5040

Mailing Address1100 Nw 12th StFruitland, ID 83619-5040 · (208) 452-6556

Phone(208) 452-6556

Sole ProprietorNo

Enumeration DateApril 10, 2017

Last NPPES UpdateAugust 5, 20253 updates tracked since enumeration

NPPES CertifiedAugust 5, 2025

✔ NPI 1922531508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in ID · M-15894

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1100 NW 12TH ST, Fruitland, ID 83619

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theodore Gross 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83619 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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.

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