Active NPI
Mikel Ross, AGNP-BC
- Adult Health Nurse Practitioner
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F308795
- Practice address
- 345 E 68TH St Apt 4B
New York, NY 10065-5629 - Phone
- (314) 302-7369
- NPI assigned
- Aug 3, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F308795 | NY | Primary |
Addresses
Primary practice location
345 E 68TH St Apt 4B
New York, NY 10065-5629
Mailing address
345 E 68TH St Apt 4B
New York, NY 10065-5629
Phone (314) 302-7369
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000
Hospital & facility affiliations
- Memorial Hospital for Cancer and Allied Diseases
Merit-based Incentive Payment System (MIPS)
- Final score
- 75.5 of 100
- Quality
- 60.62
- Improvement activities
- 40
- Cost
- 73.87
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F308795 | NY | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Medical Consultation Group | Current | Accepting new patients | |
| Memorial Solid Tumor Group | Current | Accepting new patients |
Locations
633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000
1275 York Ave
New York, NY 10065
Phone (212) 639-3813
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- mross40472@mskcc.direct-ci.com
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.
-
- Internal Medicine Physician
- New York, NY
- NPI 1699746172
-
- Internal Medicine Physician
- New York, NY
- NPI 1053382523
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New York, NY
- NPI 1700887411
-
- Special Hospital
- New York, NY
- NPI 1770046351
-
- General Acute Care Hospital
- Basking Ridge, NJ
- NPI 1659385474
-
- General Acute Care Hospital
- Montvale, NJ
- NPI 1841650330
-
- General Acute Care Hospital
- Middletown, NJ
- NPI 1528428521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533254400000",
"number": "1376021097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 E 68TH ST APT 4B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100655629",
"telephone_number": "314-302-7369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 E 68TH ST APT 4B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100655629",
"telephone_number": "314-302-7369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "MIKEL",
"credential": "AGNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-03",
"last_updated": "2018-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F308795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.