Active NPI
Mitchell J. Ross, M.D.
- Procedural Dermatology Physician
- Cos Cob, CT
National Provider Identifier
1497872659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Procedural Dermatology Physician
- License
- 031394
- Practice address
- 40 E Putnam Ave
Cos Cob, CT 06807-2600 - Phone
- (206) 869-3439
- Fax
- (203) 869-4206
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | 031394 | CT | Primary |
Addresses
Primary practice location
40 E Putnam Ave
Cos Cob, CT 06807-2600
Mailing address
40 E Putnam Ave
Cos Cob, CT 06807-2600
Phone (206) 869-3439
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 031394 | CT | MD | Procedural Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497872659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 E PUTNAM AVE",
"city": "COS COB",
"state": "CT",
"postal_code": "068072600",
"telephone_number": "206-869-3439",
"fax_number": "203-869-4206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 E PUTNAM AVE",
"city": "COS COB",
"state": "CT",
"postal_code": "068072600",
"telephone_number": "206-869-3439",
"fax_number": "203-869-4206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "MITCHELL",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "CT",
"license": "031394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cos Cob, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.