Theodore Ross, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME179187 Issued in FL

Practice address

109 N Doverplum Ave
Kissimmee, FL 34758-3309

Phone

(407) 943-8600

Fax

(833) 464-3641

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, FL2 enrollments

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 2

Specialty

Internal Medicine

Education

Washington University School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Illinois Healthcare Foundation IncGroup PAC ID 1456256874, shared by 35 NPIs, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Touchette Regional Hospital Inc Hospital, Centreville, IL, CCN 140077
• Memorial Hospital Hospital, Belleville, IL, CCN 140185
• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
• Gateway Regional Medical Center Hospital, Granite City, IL, CCN 140125

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theodore.ross.1@9559.direct.athenahealth.com

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.

• Southern Illinois Healthcare Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Centreville, IL
  • NPI 1609813500

  Internal Medicine

  Medicare reassignment NPD
• Primary Care Medical Services of Poinciana Inc

  • Federally Qualified Health Center (FQHC)
  • Kissimmee, FL
  • NPI 1376093609
  Medicare reassignment
• Southern Illinois Healthcare Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Waterloo, IL
  • NPI 1821813247
  NPD
• Southern Illinois Healthcare Foundation, Inc

  • Federally Qualified Health Center (FQHC)
  • Alton, IL
  • NPI 1356377568
  NPD
• Southern Illinois Healthcare Foundation, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Saint Louis, IL
  • NPI 1306902945

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• American Healthcare Systems Illinois LLC

  • General Acute Care Hospital
  • Granite City, IL
  • NPI 1326765884
  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Urgent Care Clinic/Center
  • Glen Carbon, IL
  • NPI 1700586344

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Clinic/Center
  • Edwardsville, IL
  • NPI 1760182307

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Clinic/Center
  • Waterloo, IL
  • NPI 1770283301

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Urgent Care Clinic/Center
  • Columbia, IL
  • NPI 1982304523

  Hospital

  Care Compare affiliation
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation
• Protestant Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation
• Touchette Regional Hospital Inc

  • Psychiatric Hospital Unit
  • Cahokia Heights, IL
  • NPI 1750992459
  Care Compare affiliation
• Touchette Regional Hospital Inc

  • Emergency Medicine Physician
  • Cahokia Heights, IL
  • NPI 1922019926

  Hospital

  Care Compare affiliation
• Touchette Regional Hospital, Inc.

  • General Acute Care Hospital
  • Cahokia Heights, IL
  • NPI 1427111046
  Care Compare affiliation

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1285720508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 BILL BECK BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347449516",
            "telephone_number": "407-943-8600",
            "fax_number": "407-932-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N DOVERPLUM AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347583309",
            "telephone_number": "407-943-8600",
            "fax_number": "833-464-3641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6010 Bond Ave",
            "address_purpose": "LOCATION",
            "city": "East Saint Louis",
            "state": "IL",
            "postal_code": "622072328",
            "country_code": "US",
            "telephone_number": "618-337-8153",
            "fax_number": "618-337-8905",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2166 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Granite City",
            "state": "IL",
            "postal_code": "620404700",
            "country_code": "US",
            "telephone_number": "618-452-3301",
            "fax_number": "618-452-3112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036075238",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME179187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theodore.ross.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "6010 Bond Ave",
            "city": "East Saint Louis",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622072328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ross Cancer Center, LLC
• Melody Ross
• Moriah Rachelle Ross
• Stacey Jo Ross
• Susan Ross, MD
• Maritza I Rosso
• Christina Roth
• Susan Rotunno
• Joseph Bernard Roudis, PHARM.D.
• Mark J Round, M.D.

• Internal Medicine Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.