Individual provider Active NPI

Theresa J Ross, MD

  • General Practice Physician
  • Monroe, LA
National Provider Identifier
1528072188
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
017867 Issued in LA
Practice address
112 Saint John St
Monroe, LA 71201-7322
Phone
(318) 387-5681
Fax
(318) 322-9957
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 017867 LA Primary

Addresses

Primary practice location

112 Saint John St
Monroe, LA 71201-7322

Mailing address

130 Desiard St
Suite 355
Monroe, LA 71201-7319
Phone (318) 807-7875

Other identifiers 1

IdentifierTypeStateIssuer
1342106MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20070403000090 LA Practitioner - General Practice 2365546256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Louisiana State University School of Medicine in Shreveport, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baton Rouge Clinic, a Medical CorporationGroup PAC ID 1254317001, 285 clinicians

Practice addresses (Care Compare)

112 Saint John St
Monroe, LA 71201-7322
Phone (318) 387-5681

2516 Broadmoor Blvd
Monroe, LA 71201-2988
Phone (318) 998-3426

7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 246-9790

920 Oliver Rd
Monroe, LA 71201-5702
Phone (318) 998-3426

Hospital & facility affiliations

  • Elara Caring Home health agency, Monroe, LA, CCN 197276
  • Fmol Health St Francis Hospital, Monroe, LA, CCN 190125
  • Monroe Surgical Hospital Hospital, Monroe, LA, CCN 190245
  • Glenwood Regional Medical Center Hospital, West Monroe, LA, CCN 190160

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as apm
Quality
60.04
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Clinic, a Medical Corporation CurrentSince Oct 1, 2024 Accepting new patients
Affinity Health Group, LLC Family Medicine CurrentSince Apr 1, 2009 Accepting new patients
Affinity Health Group, LLC CurrentSince Apr 1, 2009 Accepting new patients
Baton Rouge Clinic, a Medical Corporation CurrentSince Oct 1, 2024 Accepting new patients

Locations

7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790

130 Desiard St
Ste 355
Monroe, LA 71201
Phone (318) 807-7875

112 Saint John St
Monroe, LA 71201
Phone (318) 387-5681

2408 Broadmoor Blvd
Ste 2
Monroe, LA 71201
Phone (318) 807-0525

920 Oliver Rd
Monroe, LA 71201
Phone (318) 807-6267

109 Regency Pl
West Monroe, LA 71291
Phone (318) 361-0581

Interoperability endpoints

  • Direct secure messaging: tross127073@direct.casso.us.com

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 4

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1528072188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DESIARD ST",
            "address_2": "SUITE 355",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017319",
            "telephone_number": "318-807-7875",
            "fax_number": "318-812-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SAINT JOHN ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017322",
            "telephone_number": "318-387-5681",
            "fax_number": "318-322-9957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "THERESA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "017867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1342106",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.