Individual provider Active NPI

Joel S Ross, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Long Branch, NJ
National Provider Identifier
1306982392
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MA47821 Issued in NJ
Practice address
80 Pavilion Avenue
Long Branch, NJ 07740
Phone
(732) 571-1535
Fax
(732) 571-5115
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MA47821 NJ Primary

Addresses

Primary practice location

80 Pavilion Avenue
Long Branch, NJ 07740

Mailing address

4 Industrial Way W
Eatontown, NJ 07724-4238
Phone (732) 263-0101

Other identifiers 1

IdentifierTypeStateIssuer
0904503MedicaidNJ

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
I20190102002707 NJ Practitioner - Internal Medicine 0749412542 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA47821NJMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Nurse Association of Central Jersey, Inc. CurrentSince Nov 12, 2018 Accepting new patients
Visiting Nurse Association of Central Jersey, Inc. CurrentSince Nov 12, 2018 Accepting new patients

Locations

23 Main St
#D1
Holmdel, NJ 07733
Phone (732) 224-6914

3600 State Route 66
Fl 4
Tinton Falls, NJ 07753
Phone (732) 241-4194

Organizations & group practices 2

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1306982392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 INDUSTRIAL WAY W",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077244238",
            "telephone_number": "732-263-0101",
            "fax_number": "732-263-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 PAVILION AVENUE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "07740",
            "telephone_number": "732-571-1535",
            "fax_number": "732-571-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JOEL",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "MA47821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0904503",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

Verify at the official NPI Registry.