Samuel E Ross, M.D.
Individual provider Active NPI Emergency Medicine Physician · Wakeman, OH
NPI 1275979296 · NPPES record last updated Sep 17, 2025
Key facts
- NPI
- 1275979296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 35.135213 (OH)
- Practice address
- 24 Hyde St
Wakeman, OH 44889-9301 - Phone
- (440) 839-2226
- Fax
- (440) 839-1339
- NPI assigned
- May 16, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 18
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- M Medical Mi PLLC
Pai Participant 1 LLC
Licking Memorial Health Professionals
Practice addresses (Care Compare)
1920 Cleveland Rd W
Huron, OH 44839-1249
Phone (419) 433-4990
20 W Locust St
Newark, OH 43055-5520
Phone (220) 564-4835
Hospital & facility affiliations
- Southern Care Youngstown
- Premier Hospice
- Seasons Hospice & Palliative Care of Michigan
- Buckeye Hospice and Palliative Care Services
- Fisher-Titus Hospital
- Licking Memorial Hospital
- Mercy Health - Tiffin Hospital
- Bellevue Hospital
- Firelands Regional Medical Center
- Medilodge of St. Clair
- Medilodge of Yale
- Admirals Pointe Nursing & Rehabilitation
- Majestic Care of Clyde
- Autumnwood Care Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in MI, OH, FL, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Premier Hospice, LLC |
Hospice | Contracted Managing Employee | Nov 10, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170607001747 | MI | Practitioner - Family Practice |
8921223272 | Reassigns benefits to 3 organizations |
| I20190205001779 | OH | Practitioner - Family Practice | 8921223272 | Reassigns benefits to 5 organizations |
| I20260602002783 | FL | Practitioner - Emergency Medicine | 8921223272 | Reassigns benefits to 1 organization |
| I20260608000504 | VA | Practitioner - Emergency Medicine | 8921223272 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.135213 | OH | MD | Emergency Medicine Physician |
| 4301108033 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fisher-Titus Medical Center | Current | Accepting new patients | |
| M Medical Mi PLLC | Current |
Accepting new patients | |
| Pai Participant 18 PC | Current |
Accepting new patients | |
| M Medical Mi PLLC | Current |
Accepting new patients | |
| Licking Memorial Health Professionals | Family Medicine | Current |
Accepting new patients |
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients | |
| Licking Memorial Professional Corporation | Current |
Accepting new patients | |
| Pai Participant 1 LLC | Current |
Accepting new patients | |
| Fisher-Titus Medical Care LLC | Family Medicine | Current |
Accepting new patients |
| Signify Health, LLC | Current |
Accepting new patients | |
| Orchardview Physicians | Past |
Accepting new patients | |
| Medilodge of Yale Inc | Past | Accepting new patients | |
| Optalis Kingsford Opco LLC | Past | Accepting new patients | |
| Huron Health Care Center, Inc. | Past | Accepting new patients | |
| St Clair Opco LLC | Past | Accepting new patients |
Locations
5201 Conner St
Detroit, MI 48213
Phone (313) 571-5555
3003 W Grand River Ave
Howell, MI 48843
Phone (517) 323-9133
13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620
230 Cherry St
Chillicothe, OH 45601
Phone (740) 773-6470
175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902
1920 Cleveland Rd W
Huron, OH 44839
Phone (419) 433-4990
1320 W Main St
Newark, OH 43055
Phone (740) 348-4151
20 W Locust St
Newark, OH 43055
Phone (220) 564-4835
120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806
14 Westgate Dr
Newark, OH 43055
Phone (220) 564-7500
272 Benedict Ave
Norwalk, OH 44857
Phone (419) 668-1341
54 S Washington St
Tiffin, OH 44883
Phone (419) 447-6885
24 Hyde St
Wakeman, OH 44889
Phone (440) 839-0039
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Interoperability endpoints
- samuelross@bpsoh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301108033 | MI | |
| Emergency Medicine Physician | 207P00000X | 35.135213 | OH | Yes |
| Family Medicine Physician | 207Q00000X | 35.135213 | OH |
Addresses
Primary practice location
24 Hyde St
Wakeman, OH 44889-9301
Mailing address
272 Benedict Ave
Norwalk, OH 44857-2374
Phone (419) 668-8101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0330079 | Medicaid | OH |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sross43191@lickingmemorial.medicity.net | Licking Memorial Health Professionals |
Other providers in Wakeman, OH
- Premier Health Chiropractic, LLC
- Vanessa Radcliffe
- Melinda D Riedy
- Allison P Ringle
- Rising Sun Centers, LLC
- Zsolt K Sinka
- Brooke Smith
- Deborah Jean Sommers
- Jessie Lynn Spiegelberg
- Jodi Startup
All providers in Wakeman, OH · Emergency Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.