Individual provider Active NPI

Susan Dickinson Ross, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1659407245
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
57927 Issued in MA
Practice address
800 Washington St
Tufts Medical Center
Boston, MA 02111-1552
Phone
(617) 636-5000
NPI assigned
Feb 26, 2007
Last updated
Jan 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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 57927 MA Primary

Addresses

Primary practice location

800 Washington St
Tufts Medical Center
Boston, MA 02111-1552

Mailing address

800 Washington St
Tufts Medical Center
Boston, MA 02111-1552
Phone (617) 636-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20110328000287 MA Practitioner - Internal Medicine 1557544632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tufts Medical Center Community Care IncGroup PAC ID 4981915659, 21 clinicians

Practice addresses (Care Compare)

1690 Crown Colony Dr
Quincy, MA 02169-0913
Phone (857) 403-4600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57927MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tufts Medical Center Community Care, Inc Internal Medicine CurrentSince Feb 1, 2018 Accepting new patients
Pratt Medical Group, Inc CurrentSince Jun 12, 2017 Accepting new patients
Pratt Medical Group, Inc Internal Medicine Current Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

325 Wood Rd
Ste 210
Braintree, MA 02184
Phone (781) 356-3336

1690 Crown Colony Dr
Quincy, MA 02169
Phone (781) 237-3395

Interoperability endpoints

  • Direct secure messaging: sross46819@tuftsmedicine.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1659407245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "TUFTS MEDICAL CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "TUFTS MEDICAL CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "SUSAN DICKINSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "57927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.