Individual provider Active NPI

Andrew Edward Ross

  • Otolaryngology Physician
  • Detroit, MI
National Provider Identifier
1649833013
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
5101027692 Issued in MI
Practice address
4160 John R St Ste 1007
Detroit, MI 48201-2017
Phone
(313) 966-9471
Fax
(313) 966-9471
NPI assigned
Apr 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 55101027692 MI
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X 5101027692 MI Primary

Addresses

Primary practice location

4160 John R St Ste 1007
Detroit, MI 48201-2017

Mailing address

2342 John R Rd Apt 105
Troy, MI 48083-2569
Phone (619) 261-4371

Other practice location 1

3901 Beaubien St
Detroit, MI 48201-2119
Phone (619) 261-4371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240710003475 MI Practitioner - Otolaryngology 6406189794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Oklahoma State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

4160 John R St
Suite 1007
Detroit, MI 48201-2017
Phone (313) 966-9472

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.26 of 100Reported as group
Quality
64.16
Promoting interoperability
100
Improvement activities
40
Cost
73.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55101027692MIMDFacial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan CurrentSince Jul 1, 2024 Accepting new patients

Locations

1 William Carls Dr
Ste G131
Commerce Twp, MI 48382
Phone (248) 242-7330

1611 Monroe St
Dearborn, MI 48124
Phone (313) 254-4039

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

6001 W Outer Dr
Ste 203
Detroit, MI 48235
Phone (313) 345-8880

4160 John R St
Ste 1007
Detroit, MI 48201
Phone (313) 966-9471

Organizations & group practices 1

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 5

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": "1555718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1649833013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 JOHN R RD APT 105",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480832569",
            "telephone_number": "619-261-4371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST STE 1007",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012017",
            "telephone_number": "313-966-9471",
            "fax_number": "313-966-9471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Beaubien St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012119",
            "country_code": "US",
            "telephone_number": "619-261-4371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "ANDREW",
        "middle_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-20",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MI",
            "license": "55101027692",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "5101027692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.