Individual provider Active NPI

Abigail Madison Ross, PA-C

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1043918303
Registry record updated May 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA064163 Issued in PA
Practice address
5401 N Broad St
Philadelphia, PA 19141
Phone
(215) 456-8220
NPI assigned
Feb 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA064163 PA Primary

Addresses

Primary practice location

5401 N Broad St
Philadelphia, PA 19141

Mailing address

5401 N Broad St
Philadelphia, PA 19141
Phone (215) 456-7890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230531000174 PA Practitioner - Physician Assistant 9032576467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5401 Old York Rd
Philadelphia, PA 19141-3030
Phone (215) 456-3930

5401 Old York Rd Klein BLDG
Phila, PA 19141-3030

5501 Old York Rd
Phila, PA 19141-3018

5501 Old York Rd Levy 2
Einstein Pediatrics Associates
Philadelphia, PA 19141-3018
Phone (215) 456-6786

5501 Old York Rd WCB 4TH FLR
Einstein CT Surgery Assoc
Philadelphia, PA 19141-3018
Phone (215) 456-8270

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA064163PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Apr 1, 2023 Accepting new patients
Einstein Practice Plan Inc CurrentSince Apr 1, 2023 Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

5401 Old York Rd
#B
Philadelphia, PA 19141
Phone (215) 324-3399

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

5401 Old York Rd
Ste 505
Philadelphia, PA 19141
Phone (215) 456-6933

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684540800000",
    "number": "1043918303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19141",
            "telephone_number": "215-456-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19141",
            "telephone_number": "215-456-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "ABIGAIL",
        "middle_name": "MADISON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-05-20",
        "certification_date": "2023-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA064163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.