Michael A Ross, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

32874-020 Issued in WI

Practice address

1789 Shawano Ave
Green Bay, WI 54303

Phone

(920) 499-1428

Fax

(920) 499-5808

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• CT Imaging LLC

  • Diagnostic Radiology Physician
  • Green Bay, WI
  • NPI 1821023961
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257379200000",
    "number": "1124053582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3006",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54303",
            "telephone_number": "920-499-1428",
            "fax_number": "920-499-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1789 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54303",
            "telephone_number": "920-499-1428",
            "fax_number": "920-499-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "32874-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE MEDICAI",
            "identifier": "1018926002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300030636",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31799500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH",
            "identifier": "567565",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH",
            "identifier": "14448",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4723997",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4767230",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Rosera
• Elizabeth Rosiejka
• Emily Roskom
• Casey M Ross, APNP
• Kathleen M Ross, LPC
• Kevin Peter Rosteing, MD, MSMI
• Taylor Rae Rotherham-Decremer, NP
• Cheryl K Rotherham, M.S., L.C.S.W.
• Kara Jean Rottier, FNP
• Stephanie J Rottier, LPC-IT

• Diagnostic Radiology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Diagnostic Radiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.