NPIMap

Individual provider Active NPI

Glenn Stuart Ross, M.D.

  • Internal Medicine Physician
  • Newport News, VA
National Provider Identifier
1285609388
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101046687 Issued in VA
Practice address
11803 Jefferson Ave
Ste 140
Newport News, VA 23606-2565
Phone
(757) 594-1837
Fax
(757) 594-1828
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101046687 VA Primary

Addresses

Primary practice location

11803 Jefferson Ave
Ste 140
Newport News, VA 23606-2565

Mailing address

11803 Jefferson Ave
Ste 140
Newport News, VA 23606-2565
Phone (757) 594-1837

Other identifiers 1

IdentifierTypeStateIssuer
005870828MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20100330000596 VA Practitioner - Internal Medicine 7810023769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
JS Weill Medical College, Cornell University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

11803 Jefferson Ave
Suite 140
Newport News, VA 23606-4390
Phone (757) 694-1839

Hospital & facility affiliations

  • Sentara Home Care Services Home health agency, Newport News, VA, CCN 497294
  • Amedisys Home Health of Newport News Home health agency, Hampton, VA, CCN 497091
  • Virginia Health Home Care Home health agency, Newport News, VA, CCN 497677
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066
  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Internal Medicine CurrentSince Aug 1, 1998 Accepting new patients

Locations

11803 Jefferson Ave
Ste 140
Newport News, VA 23606
Phone (757) 594-1803

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

Interoperability endpoints

  • Direct secure messaging: gross13097@direct.sentara.net

Organizations & group practices 1

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.

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1285609388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11803 JEFFERSON AVE",
            "address_2": "STE 140",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062565",
            "telephone_number": "757-594-1837",
            "fax_number": "757-594-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11803 JEFFERSON AVE",
            "address_2": "STE 140",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062565",
            "telephone_number": "757-594-1837",
            "fax_number": "757-594-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "GLENN",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101046687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005870828",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.