2026 NPPES data Legal Medicine NPI 1538129879 MD
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THOMAS GROSS, MD

Legal Medicine in ALBUQUERQUE, New Mexico. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
24
Medicare Part D claims · Legal Medicine avg: 3K
MIPS score
97.5814/100
▲ 14 pts above national avg 83.1 · [object Object]
What the federal data reveals: THOMAS GROSS, MD is a Legal Medicine ([object Object]) practicing in ALBUQUERQUE, New Mexico with a Medicare Part D prescribing footprint of 24 claims . Their CMS MIPS Final Score of 97.5814/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities .

What stands out: THOMAS GROSS, MD reported a CMS MIPS final score of 97.5814 out of 100, above the 83.1 national average, and filed 24 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

THOMAS GROSS, MD at a glance

High performer (top quartile)

NPI registry status

Active

Issued 03/23/2006

NPI 1538129879

Primary specialty

Legal Medicine

Niche

1,067 US NPIs in this specialty

Medicare Part D claims

24 99% vs specialty avg

2023 prescription claims

Specialty avg: 2,821

MIPS final score

97.5814/100 14.481400000000008% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in New Mexico

How Legal Medicine compares to other specialties among New Mexico providers

New Mexico providers

Legal Medicine share within New Mexico

1. Legal Medicine42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Legal Medicine share within New Mexico

Medicare quality performance — MIPS

THOMAS GROSS, MD's 2023 MIPS final score plotted against the Legal Medicine national average

High performer (top quartile)
MIPS Final Score
97.5814/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Legal Medicine) — 97.5814/100 vs national avg 83.1

0%100%National avg83%97.6%
MIPS final score (Legal Medicine) — 97.5814/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

THOMAS GROSS, MD is a Legal Medicine provider practicing in ALBUQUERQUE, New Mexico, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1538129879. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

THOMAS GROSS, MD appears in the CMS NPPES registry as a Legal Medicine provider holding MD credentials at 6701 JEFFERSON ST NE, ALBUQUERQUE, NM, 87109, with a listed phone of (505) 727-6200. NPI 1538129879 was issued on 03/23/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what GROSS most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 24 prescription claims written by this provider, covering N/A Medicare beneficiaries and totaling roughly $374 in drug spend. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 97.5814/100 for the 2023 performance year (Quality 86.5348), compared with the national average of 83.1.

Legal Medicine is a narrow specialty nationwide, with 1,067 enrolled providers across 51 states and an average of 2,821 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

6701 JEFFERSON ST NE
ALBUQUERQUE, NM 87109

Provider Details

NPI 1538129879
Specialty Legal Medicine
Credentials MD
Gender Male
NPI Issued 03/23/2006

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

97.5814
Final Score
Avg: 83.1
86.5348
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where THOMAS GROSS, MD bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.

SOUTHWEST GASTROENTEROLOGY ASSOCIATES
ALBUQUERQUE, NM

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

24
Total Claims
$374
Total Drug Cost
N/A
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
32
Total Day Supply
810
Generic Drug Cost
$331

Patient Demographics

Average Patient Age
74.8 years
Avg HCC Risk Score
0.42

Legal Medicine Overview

How THOMAS GROSS, MD fits within the Legal Medicine landscape nationally.

1,067
Legal Medicine Providers in US
51
States with Legal Medicine
2,821
Avg Claims per Provider

THOMAS GROSS, MD's 24 claims are below the specialty average of 2,821.

Nearby Legal Medicine Providers in New Mexico

Other clinicians with the same primary specialty enrolled in New Mexico, drawn from the same CMS NPPES roster as GROSS.

Compare Legal Medicine nationally: see state-by-state distribution →

Frequently Asked Questions

What is THOMAS GROSS, MD's specialty?
THOMAS GROSS, MD specializes in Legal Medicine and practices in ALBUQUERQUE, New Mexico. Credentials: MD.
How much does THOMAS GROSS, MD prescribe under Medicare Part D?
In 2023, THOMAS GROSS, MD wrote 24 Medicare Part D claims totaling $374 in drug costs for N/A beneficiaries.
What is THOMAS GROSS, MD's Medicare quality score?
THOMAS GROSS, MD has a CMS MIPS Final Score of 97.5814/100 (Quality: 86.5348). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is THOMAS GROSS, MD located?
THOMAS GROSS, MD is located at 6701 JEFFERSON ST NE, ALBUQUERQUE, NM, 87109. Phone: (505) 727-6200.
What is THOMAS GROSS, MD's NPI number?
THOMAS GROSS, MD's National Provider Identifier (NPI) is 1538129879, issued on 03/23/2006.
How many Legal Medicine providers are there in the US?
There are 1,067 Legal Medicine providers across 51 states in the US. The average Legal Medicine provider writes 2,821 Medicare Part D claims per year.
Does THOMAS GROSS, MD accept Medicare?
THOMAS GROSS, MD appears in CMS Medicare data with 24 Part D claims and N/A Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify THOMAS GROSS, MD's credentials?
THOMAS GROSS, MD's NPI is 1538129879 with credentials MD. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology