Individual provider Active NPI

Mariana Pagan Rosso, MD

  • Family Medicine Physician
  • Jackson, TN
National Provider Identifier
1316523301
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
71174 Issued in TN
Practice address
620 Skyline Dr
Jackson, TN 38301-3923
Phone
(731) 541-5000
NPI assigned
Mar 22, 2021
Last updated
Dec 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 71174 TN
Family Medicine Physician 207Q00000X 71174 TN Primary

Addresses

Primary practice location

620 Skyline Dr
Jackson, TN 38301-3923

Mailing address

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20210721002754 TN Practitioner - Emergency MedicinePractitioner - Family Practice 9133522642 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians
Emergency Medicine Services of TN, PCGroup PAC ID 3173989837, 144 clinicians
Emergency Medical Care Facilities PCGroup PAC ID 6103837877, 57 clinicians

Practice addresses (Care Compare)

1201 Bishop St
Union City, TN 38261-5403
Phone (901) 885-2410

2000 Ava PL
Nolensville, TN 37135-1108
Phone (615) 986-2820

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as apm
Quality
85.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71174TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WT University Medical Associates Inc Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Feb 26, 2025 Accepting new patients
Hospital Medicine Services of Tennessee PC Family Medicine CurrentSince Sep 9, 2024 Accepting new patients
Emergency Medical Care Facilities PC Emergency Medicine CurrentSince Oct 13, 2024 Accepting new patients
Emergency Medicine Services of TN, PC Emergency Medicine CurrentSince Oct 9, 2025 Accepting new patients
University of Tennessee Family Medicine Current Accepting new patients

Locations

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

175 Hospital Dr
Camden, TN 38320
Phone (731) 584-6135

631 Rb Wilson Dr
Huntingdon, TN 38344
Phone (731) 986-2933

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932

367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

700 W Forest Ave
Fl 5
Jackson, TN 38301
Phone (731) 423-1932

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

4039 Highland St
Ste 1
Milan, TN 38358
Phone (731) 723-3668

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

2000 Ava Pl
Nolensville, TN 37135
Phone (615) 986-2820

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Interoperability endpoints

  • Direct secure messaging: mpaganrosso681048@direct.bmhcc.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1316523301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGAN ROSSO",
        "first_name": "MARIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "71174",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "71174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.