Matthew Gross, CNP
Nurse Practitioner, Family in Rapid City, SD. Individual provider (NPI-1).
NPI number1154847481
StatusActive
Last updated in NPPESMar 17, 2018
Details
- NPI
- 1154847481
- Entity type
- Individual (NPI-1)
- Name
- Mr. Matthew Gross
- Credential
- CNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 17, 2017
- Last updated
- Mar 17, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | CP001253 | SD | Yes |
Practice location
4150 5th StRapid City, SD 57701-6022
Phone 605-755-4300
Mailing address
1115 Sitka StRapid City, SD 57701-2085
Other practice locations
353 Fairmont Blvd
Rapid City, SD 57701-7375
Rapid City, SD 57701-7375
Phone 605-755-1000
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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