NPIMap

Individual provider Active NPI

Michael William Vincent Ross, DO

  • Family Medicine Physician
  • Batavia, IL
National Provider Identifier
1366855454
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.141310 Issued in IL
Practice address
2500 W Fabyan Pkwy
Batavia, IL 60510-1572
Phone
(630) 879-2110
Fax
(630) 762-4779
NPI assigned
Jun 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.141310 IL Primary

Addresses

Primary practice location

2500 W Fabyan Pkwy
Batavia, IL 60510-1572

Mailing address

2500 W Fabyan Pkwy
Batavia, IL 60510-1572
Phone (630) 879-2110

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address mross205150@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170922000036 IL Practitioner - Family Practice 8426276627 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, shared by 39 NPIs, 3,081 clinicians

Practice addresses (Care Compare)

2500 W Fabyan Pkwy
Batavia, IL 60510-1572
Phone (630) 879-2110

4025 N Western Ave
Chicago, IL 60618-3726
Phone (773) 275-7700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.141310ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corporation CurrentSince Sep 11, 2017 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Oct 1, 2022 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 11, 2017 Accepting new patients

Locations

2357 Sequoia Dr
Aurora, IL 60506
Phone (630) 859-6700

1221 N Highland Ave
Aurora, IL 60506
Phone (630) 859-6700

2500 W Fabyan Pkwy
Batavia, IL 60510
Phone (630) 879-2110

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

28594 Network Pl
Chicago, IL 60673

4025 N Western Ave
Chicago, IL 60618
Phone (773) 275-7700

29373 Network Pl
Chicago, IL 60673

Organizations & group practices 4

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 11

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": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1366855454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W FABYAN PKWY",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101572",
            "telephone_number": "630-879-2110",
            "fax_number": "630-762-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W FABYAN PKWY",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101572",
            "telephone_number": "630-879-2110",
            "fax_number": "630-762-4779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM VINCENT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-05",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.141310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2500 W Fabyan Pkwy",
            "city": "Batavia",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605101572",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mross205150@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2500 W Fabyan Pkwy",
            "city": "Batavia",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605101572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Batavia, IL

Sources for this page

Verify at the official NPI Registry.