Individual provider Active NPI

Jenny Ross

  • Anatomic Pathology & Clinical Pathology Physician
  • Chicago, IL
National Provider Identifier
1750640769
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
291912 Issued in NY
Practice address
680 N Lake Shore Dr Ste 1000
Chicago, IL 60611-8709
Phone
(312) 695-9797
NPI assigned
May 10, 2012
Last updated
Mar 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036.142885 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD457159 PA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 291912 NY Primary

Addresses

Primary practice location

680 N Lake Shore Dr Ste 1000
Chicago, IL 60611-8709

Mailing address

62 Brighton 2ND PL PH B
Brooklyn, NY 11235-7055
Phone (540) 520-9081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230131000801 NY Practitioner - Pathology 6507133717 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christopher I Sayegh MD PCGroup PAC ID 1052836137, 2 clinicians
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

258 High Ave
Nyack, NY 10960-2407
Phone (845) 600-4876

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.142885ILMDAnatomic Pathology & Clinical Pathology Physician
MD457159PAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Jun 20, 2025 Accepting new patients
Christopher I Sayegh MD PC CurrentSince Sep 1, 2025 Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

258 High Ave
Nyack, NY 10960
Phone (845) 348-2550

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1750640769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 BRIGHTON 2ND PL PH B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357055",
            "telephone_number": "540-520-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606118709",
            "telephone_number": "312-695-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JENNY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-10",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036.142885",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD457159",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "291912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.