Active NPI
Ross Bennett Andelman, M.D.
- Child & Adolescent Psychiatry Physician
- Concord, CA
National Provider Identifier
1023178019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- G72412
- Practice address
- 2425 Bisso LN
Site 280
Concord, CA 94520-4897 - Phone
- (925) 646-5915
- Fax
- (925) 646-5811
- NPI assigned
- Dec 11, 2006
- Last updated
- Mar 12, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G72412 | CA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | G72412 | CA | Primary |
Addresses
Primary practice location
2425 Bisso LN
Site 280
Concord, CA 94520-4897
Mailing address
2425 Bisso LN
Site 280
Concord, CA 94520-4897
Phone (925) 646-5915
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 27, 2025 through Apr 27, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G72412 | CA | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583971200000",
"number": "1023178019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 BISSO LN",
"address_2": "SITE 280",
"city": "CONCORD",
"state": "CA",
"postal_code": "945204897",
"telephone_number": "925-646-5915",
"fax_number": "925-646-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 BISSO LN",
"address_2": "SITE 280",
"city": "CONCORD",
"state": "CA",
"postal_code": "945204897",
"telephone_number": "925-646-5915",
"fax_number": "925-646-5811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDELMAN",
"first_name": "ROSS",
"middle_name": "BENNETT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2020-03-12",
"certification_date": "2020-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G72412",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "G72412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.