Individual provider Active NPI

Gilbert Lee Ross, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1417158056
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
116347 Issued in NY
Practice address
2015 Grand Concourse Apt 34E
Bronx, NY 10453-4303
Phone
(718) 299-7295
Fax
(718) 299-6797
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 116347 NY Primary

Addresses

Primary practice location

2015 Grand Concourse Apt 34E
Bronx, NY 10453-4303

Mailing address

3198 Grand Concourse
Bronx, NY 10458-1000
Phone (718) 618-0401

Other identifiers 1

IdentifierTypeStateIssuer
116347OtherNYLICENSE NUMBER

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
I20060202000292 NY Practitioner - Internal MedicinePractitioner - Rheumatology 2961416680 Reassigns benefits to 1 organization
Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
116347NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Damian Family Care Centers, Inc. CurrentSince Oct 14, 2018 Accepting new patients
Damian Family Care Centers, Inc. CurrentSince Oct 14, 2018 Accepting new patients
Booth Medical Associates PC Internal Medicine Past Accepting new patients
Han Shik Lee MD PC PastSince May 25, 2004 Accepting new patients
Atlas Ipa, LLC Internal Medicine PastSince Jul 24, 2022 Accepting new patients
Shakespeare Operating LLC PastSince Jul 24, 2022 Accepting new patients

Locations

8956 162nd St
#3
Jamaica, NY 11432
Phone (718) 297-8000

13750 Jamaica Ave
Jamaica, NY 11435
Phone (718) 298-5100

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: gilbert.ross@damian.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417158056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3198 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581000",
            "telephone_number": "718-618-0401",
            "fax_number": "347-479-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE APT 34E",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "GILBERT",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "116347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "116347",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.