Michael Ross, PA
Individual provider Active NPI Physician Assistant · San Angelo, TX
NPI 1396853396 · NPPES record last updated Jun 25, 2013
Key facts
- NPI
- 1396853396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA04079 (TX)
- Practice address
- 3502 Knickerbocker Rd
San Angelo, TX 76904-7671 - Phone
- (325) 942-8611
- Fax
- (325) 659-0180
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Concho County Hospital District
Practice addresses (Care Compare)
13 S Main St
Eden, TX 76837-0987
614 Eaker St
Eden, TX 76837-0987
Phone (325) 869-5911
PO Box
Suite 987
Eden, TX 76837-0987
Hospital & facility affiliations
- Reagan Memorial Hospital
- Concho County Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040804000935 | TX | Practitioner - Physician Assistant | 0143290676 | Reassigns benefits to 8 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shannon Clinic | Current |
Accepting new patients | |
| Sutton County Hospital District | Current |
Accepting new patients | |
| Texas Oncology PA | Current |
Accepting new patients | |
| Preferred Hospital Leasing Eldorado, Inc. | Current |
Accepting new patients | |
| Seton Hospitalist Service | Past | Accepting new patients | |
| East Texas Medical Center Healthcare Associates | Past | Accepting new patients | |
| San Angelo Emergency Medicine Associates PA | Physician Assistant | Past | Accepting new patients |
| Concho County Hospital District | Past | Accepting new patients | |
| Shannon Clinic | Past | Accepting new patients |
Locations
200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241
102 N US Highway 277
Eldorado, TX 76936
Phone (325) 853-2507
301 N N St
Midland, TX 79701
Phone (432) 620-5800
3501 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 947-6361
120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511
3502 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 747-2222
308 Hudspeth St
Sonora, TX 76950
Phone (325) 387-2521
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA04079 | TX | Yes |
Addresses
Primary practice location
3502 Knickerbocker Rd
San Angelo, TX 76904-7671
Mailing address
PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 942-8611
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 189528605 | Medicaid | TX | |
| 189528607 | Medicaid | TX | |
| 189528606 | Medicaid | TX | |
| 189528608 | Medicaid | TX |
Other providers in San Angelo, TX
- Yujun Rong
- Dawn Root
- Rooted Wellness Clinic
- Rosie L Ray
- Douglas Cole Ross
- Alyssa Rowe
- Carol M Rowley
- Cameron Alcide Roy
- Jennifer Kay Ruda
- Maddelyn Rudd
All providers in San Angelo, TX · Physician Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.