Individual provider Active NPI

Jose Augusto Ross, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Port Charlotte, FL
National Provider Identifier
1235119124
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME 70208 Issued in FL
Practice address
18338 Murdock Cir
Port Charlotte, FL 33948-1029
Phone
(941) 313-9009
Fax
(941) 623-9532
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME 70208 FL Primary

Addresses

Primary practice location

18338 Murdock Cir
Port Charlotte, FL 33948-1029

Mailing address

2725 Mayaguana CT
Punta Gorda, FL 33950-6365
Phone (941) 313-9009

Other identifiers 1

IdentifierTypeStateIssuer
110921700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070316000224 FL Practitioner - Pathology 9739282450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18338 Murdock Cir
Port Charlotte, FL 33948-1032
Phone (941) 313-9009

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 70208FLMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayshore Pathology Consultants PA Anatomic Pathology & Clinical Pathology CurrentSince Dec 5, 2013 Accepting new patients
Pathology Services PC Anatomic Pathology & Clinical Pathology Past Accepting new patients
Ameripath Kentucky Inc Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

18338 Murdock Cir
Unit 106
Port Charlotte, FL 33948

18316 Murdock Cir
Unit 106
Port Charlotte, FL 33948
Phone (877) 463-5434

18338 Murdock Cir
Port Charlotte, FL 33948
Phone (941) 313-9009

2500 Harbor Blvd
Pt Charlotte, FL 33952
Phone (941) 766-4122

18338 Murdock Cir
Ste 105
Pt Charlotte, FL 33948
Phone (941) 916-3000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1235119124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 MAYAGUANA CT",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339506365",
            "telephone_number": "941-313-9009",
            "fax_number": "941-623-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18338 MURDOCK CIR",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481029",
            "telephone_number": "941-313-9009",
            "fax_number": "941-623-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JOSE",
        "middle_name": "AUGUSTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME 70208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110921700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.