Individual provider Active NPI

Steven Ira Ross, MD

  • Gynecology Physician
  • Port Jefferson, NY
National Provider Identifier
1326022971
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
106076 Issued in NY
Practice address
49 Crooked Oak Rd
Port Jefferson, NY 11777-1157
Phone
(631) 928-8686
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 106076 NY Primary

Addresses

Primary practice location

49 Crooked Oak Rd
Port Jefferson, NY 11777-1157

Mailing address

49 Crooked Oak Rd
Port Jefferson, NY 11777-1157
Phone (631) 928-8688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250121003645 NY Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 0345258471

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106076NYMDGynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1326022971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 CROOKED OAK RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771157",
            "telephone_number": "631-928-8688",
            "fax_number": "631-928-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 CROOKED OAK RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771157",
            "telephone_number": "631-928-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "STEVEN",
        "middle_name": "IRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "106076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

Verify at the official NPI Registry.