NPIMap

Individual provider Active NPI

Samuel Ross

  • Surgery Physician
  • Charlotte, NC
National Provider Identifier
1225329816
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2017-01248 Issued in NC
Practice address
1350 S Kings Dr
Charlotte, NC 28207-2134
Phone
(704) 446-1255
NPI assigned
Apr 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2017-01248 NC Primary

Addresses

Primary practice location

1350 S Kings Dr
Charlotte, NC 28207-2134

Mailing address

1350 S Kings Dr
Charlotte, NC 28207-2134

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171211002447 NC Practitioner - General Surgery 9537427083 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians
The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

101 E W T Harris Blvd
Suite 3301F
Charlotte, NC 28262-3485
Phone (704) 403-8320

101 E WT Harris Blvd
Suite 5500
Charlotte, NC 28262-3485
Phone (704) 863-6160

1025 Morehead Medical Dr
Suite 275a
Charlotte, NC 28204-2963
Phone (704) 355-0607

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 355-7328

275 Hwy 16 N
Suite 202
Denver, NC 28037-3002
Phone (704) 732-9843

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 512-7000

Hospital & facility affiliations

  • Stein Hospice Services, Inc Hospice, Sandusky, OH, CCN 361542
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Marshfield Medical Center Hospital, Iron Mountain, MI, CCN 231342
  • Atrium Health University City Hospital, Charlotte, NC, CCN 340166

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Oct 9, 2017 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Surgery CurrentSince Sep 1, 2020 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 1, 2025 Accepting new patients
Carolinas Medical Center Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 1, 2020 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Pathology Group, PA Current Accepting new patients
Atrium Health Childrens Specialty Network Inc CurrentSince Sep 4, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 1, 2025 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jan 21, 2026 Accepting new patients
Carolinas Medical Center CurrentSince Oct 9, 2017 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Columbus Regional Healthcare System Past Accepting new patients

Locations

329 NC Highway 801 N
Bermuda Run, NC 27006
Phone (336) 716-8200

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1370 W D St
North Wilkesboro, NC 28659
Phone (336) 651-8100

Interoperability endpoints

  • Direct secure messaging: sross499544@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 9

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": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1225329816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134",
            "telephone_number": "704-446-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-29",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2017-01248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.