Individual provider Active NPI

Jennifer Allison Ross, M.D.

  • Pediatric Medical Toxicology Physician
  • Brookline, MA
National Provider Identifier
1104289461
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Medical Toxicology PhysicianTaxonomy code 2080T0002X
License
288309 Issued in MA
Practice address
2 Brookline PL
Brookline, MA 02445-7230
Phone
(617) 355-2727
NPI assigned
Apr 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 288309 MA
Pediatric Medical Toxicology Physician 2080T0002X 288309 MA Primary

Addresses

Primary practice location

2 Brookline PL
Brookline, MA 02445-7230

Mailing address

300 Longwood Ave
Boston, MA 02115-5724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220830002282 MA Practitioner - Medical ToxicologyPractitioner - Pediatric Medicine 7911381637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical ToxicologyAlso: Pediatric Medicine
Education
University of Cincinnati College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S Hospital Pediatric Associates, IncGroup PAC ID 3476541830, 333 clinicians

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
288309MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Pediatric Associates, Inc Pediatrics CurrentSince Sep 15, 2022 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

2 Brookline Pl
Brookline, MA 02445
Phone (617) 355-2727

Interoperability endpoints

  • Direct secure messaging: jross28467@direct.bostonchildrens.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1104289461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BROOKLINE PL",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457230",
            "telephone_number": "617-355-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JENNIFER",
        "middle_name": "ALLISON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-03",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "288309",
            "primary": false
        },
        {
            "code": "2080T0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Medical Toxicology",
            "state": "MA",
            "license": "288309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.