Individual provider Active NPI

Jacqueline Ross, MD

  • Allergy & Immunology Physician
  • Ocean, NJ
National Provider Identifier
1295055150
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
25MA09114400 Issued in NJ
Practice address
802 W Park Ave
Suite 213
Ocean, NJ 07712-8527
Phone
(732) 695-2555
Fax
(732) 695-2552
NPI assigned
Jun 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 25MA09114400 NJ Primary

Addresses

Primary practice location

802 W Park Ave
Suite 213
Ocean, NJ 07712-8527

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

Other identifiers 3

IdentifierTypeStateIssuer
242744ZVF5OtherNJMEDICARE PTAN
242744ZKRPOtherNJMEDICARE PTAN
0297909MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20120718000027 NJ Practitioner - Allergy/Immunology 9931365038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Partners of NJ PCGroup PAC ID 3274855499, 6 clinicians

Practice addresses (Care Compare)

802 W Park Ave
Suite 213
Ocean, NJ 07712-8526
Phone (732) 695-2555

Hospital & facility affiliations

  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Partners of NJ, PC Allergy & Immunology CurrentSince Jun 1, 2016 Accepting new patients
Allergy Partners, PLLC Allergy & Immunology Past Accepting new patients
Atlantic Allergy, Asthma & Immunology Associates of NJ LLC Allergy & Immunology PastSince Jun 1, 2016 Accepting new patients

Locations

8 Tindall Rd
Middletown, NJ 07748
Phone (732) 671-7676

802 W Park Ave
Ste 213
Ocean, NJ 07712
Phone (732) 631-8976

553 Cedar Ln
Ste A
Teaneck, NJ 07666
Phone (201) 836-6400

504 Hamburg Tpke
Ste B103
Wayne, NJ 07470
Phone (973) 790-6707

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.

Hospital & facility affiliations 3

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": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1295055150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 W PARK AVE",
            "address_2": "SUITE 213",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077128527",
            "telephone_number": "732-695-2555",
            "fax_number": "732-695-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "25MA09114400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "242744ZVF5",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "242744ZKRP",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0297909",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean, NJ

Sources for this page

Verify at the official NPI Registry.