Jacqueline Ross, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036126708 Issued in IL

Practice address

755 N York St
Elmhurst, IL 60126-1607

Phone

(331) 221-2900

Fax

(331) 221-3883

NPI assigned

Jun 26, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Coulomb Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Family Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200
• Edward Hospital Hospital, Naperville, IL, CCN 140231

Merit-based Incentive Payment System (MIPS)

Final score

84.9 of 100Reported as group

Quality

75.91

Promoting interoperability

99

Improvement activities

40

Cost

74.6

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhirprd.edward.org/fhirprd/api/FHIR/R4/
• Direct secure messaging: jross21550@direct.edward.org

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.

• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Bolingbrook, IL
  • NPI 1962452912
  Medicare reassignment NPD
• Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1013969013
  Medicare reassignment NPD
• Edward Health Ventures

  • Internal Medicine Physician
  • Lisle, IL
  • NPI 1962782052
  NPD
• Edward Hospital

  • Home Health Agency
  • Naperville, IL
  • NPI 1912930645
  NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1427069632
  Care Compare affiliation
• Elmhurst Memorial Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  Care Compare affiliation

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1609038009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261607",
            "telephone_number": "331-221-2900",
            "fax_number": "331-221-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261607",
            "telephone_number": "331-221-2900",
            "fax_number": "331-221-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JACQUELINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036126708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jross21550@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "755 N York St",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601261607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "COULOMB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Izolda Rosario, AGNP-BC
• Rose Marie OT
• Sinda Diane Rosenberg, LCSW
• Donna Jean Rosenbery, PH.D
• Ethan Ross
• Michael C Ross, PA-C
• Jamie Rosser, LPC
• Carol Roszel, RDH
• Nikola Roszko Augustynowicz, APN-CNP
• Valerie M. Roth, M.D.

• Family Medicine Physician in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.

Verify at the official NPI Registry.