Individual provider Active NPI

Carissa Marie Ross, MD

  • Obstetrics & Gynecology Physician
  • Medford, OR
National Provider Identifier
1114943115
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD26545 Issued in OR
Practice address
3170 State St
Medford, OR 97504-8450
Phone
(541) 864-8900
Fax
(541) 245-3315
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD26545 OR Primary

Addresses

Primary practice location

3170 State St
Medford, OR 97504-8450

Mailing address

3170 State St
Medford, OR 97504-8450
Phone (541) 864-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20060920000153 OR Practitioner - Obstetrics/Gynecology 5496750796 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Oklahoma College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medford Womens Clinic LLPGroup PAC ID 1254326259, 8 clinicians

Practice addresses (Care Compare)

3170 State St
Medford, OR 97504-8450
Phone (541) 864-8900

Hospital & facility affiliations

  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Oregon PC Obstetrics & Gynecology CurrentSince Jan 1, 2025 Accepting new patients
Nicholas Mills MD LLC CurrentSince Jan 18, 2020 Accepting new patients
Asante Past Accepting new patients

Locations

2951 Doctors Park Dr
Medford, OR 97504
Phone (541) 200-2646

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

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 1

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114943115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048450",
            "telephone_number": "541-864-8900",
            "fax_number": "541-245-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3170 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048450",
            "telephone_number": "541-864-8900",
            "fax_number": "541-245-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CARISSA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD26545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.