Carlotta Ross-Distin, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

016495 Issued in NY

Practice address

13329 Dennis St
Jamaica, NY 11434-4112

Phone

(347) 461-3040

NPI assigned

May 21, 2013

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

• Ms. Carlotta Ross Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Forest Hills Dermatology Group PLLC

  • Dermatology Physician
  • Kew Gardens, NY
  • NPI 1225309586
  NPD (past)

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1689010233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13329 DENNIS ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114344112",
            "telephone_number": "347-461-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13329 DENNIS ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114344112",
            "telephone_number": "347-461-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS-DISTIN",
        "first_name": "CARLOTTA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLOTTA",
            "last_name": "ROSS",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul Ira Rosen, D.M.D.
• Riva Rosenbaum
• Carly Emma Rosenberg, SLP
• Judith Rosenblatt
• Carla Rosenfeld, MA, MHC
• Jennifer KR Ross
• Shirley A Ross, QUEENS
• Maria Rossiello, DPM,PA
• Rosvolos Pharmacy Inc
• Eric S Roth, MD

• Physician Assistant in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.