NPIMap

Organization Active NPI

Ross Dermatology

  • Dermatology Physician
  • San Antonio, TX
National Provider Identifier
1134553019
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ROSS DERMATOLOGY
Practice address
2611 N Main Ave
San Antonio, TX 78212-2920
Phone
(210) 225-2769
Fax
(830) 341-5593
NPI assigned
Aug 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Authorized official

Name
Dr. Kim M Ross, M.D.NPI 1184600165
Title
Owner
Phone
(210) 225-2769

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

2611 N Main Ave
San Antonio, TX 78212-2920

Mailing address

2611 N Main Ave
San Antonio, TX 78212-2920
Phone (210) 225-2769

Other practice location 1

519 N King St Ste 103
Seguin, TX 78155-4859
Phone (210) 225-2769

Other practice location 2

309 Silverado
La Vernia, TX 78121-4948
Phone (210) 225-2769

Other identifiers 1

IdentifierTypeStateIssuer
113449601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260223001102 TX Part B Supplier - Clinic/Group Practice 1658852298 Receives reassigned benefits from 5 practitioners
Practice locations: La Vernia, TX; San Antonio, TX; Seguin, TX

National Provider Directory

National Provider Directory

Locations

309 Silverado
Lavernia, TX 78121
Phone (210) 225-2769

2611 N Main Ave
San Antonio, TX 78212
Phone (210) 225-2769

1303 McCullough Ave
Ste 525
San Antonio, TX 78212
Phone (210) 225-2769

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1134553019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 N MAIN AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782122920",
            "telephone_number": "210-225-2769",
            "fax_number": "830-341-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 N MAIN AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782122920",
            "telephone_number": "210-225-2769",
            "fax_number": "830-341-5593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "519 N King St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Seguin",
            "state": "TX",
            "postal_code": "781554859",
            "country_code": "US",
            "telephone_number": "210-225-2769",
            "fax_number": "830-341-5593",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 Silverado",
            "address_purpose": "LOCATION",
            "city": "La Vernia",
            "state": "TX",
            "postal_code": "781214948",
            "country_code": "US",
            "telephone_number": "210-225-2769",
            "fax_number": "830-341-5593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROSS DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-225-2769",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113449601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.