Individual provider Active NPI

Jennifer W Dorosh, MD

  • Emergency Medicine Physician
  • Ashland, OR
National Provider Identifier
1790910628
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD201607 Issued in OR
Practice address
280 Maple Street
Ashland, OR 97520-1552
Phone
(541) 201-4000
NPI assigned
May 21, 2009
Last updated
Jan 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301 094 181 MI
Emergency Medicine Physician 207P00000X MD201607 OR Primary
Emergency Medicine Physician 207P00000X ME142519 FL
Emergency Medicine Physician 207P00000X 56902 WI

Addresses

Primary practice location

280 Maple Street
Ashland, OR 97520-1552

Mailing address

PO Box 4749
Medford, OR 97501-0227
Phone (541) 789-4111

Other practice location 1

1500 Lee Blvd
Lehigh Acres, FL 33936-4835
Phone (239) 369-2101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191028000508 FL Practitioner - Emergency Medicine 4486810579 Reassigns benefits to 1 organization
I20201102000174 OR Practitioner - Emergency Medicine 4486810579 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301 094 181MIMDEmergency Medicine Physician
56902WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Small Hospital Innovations LLC Emergency Medicine CurrentSince Sep 16, 2019 Accepting new patients
Asante CurrentSince Oct 15, 2020 Accepting new patients
Asante Ashland Community Hospital, LLC CurrentSince Oct 15, 2020 Accepting new patients
Asante CurrentSince Oct 15, 2020 Accepting new patients
Asante Three Rivers Medical Center, LLC CurrentSince Oct 15, 2020 Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

524 W Sagamore Ave
Clewiston, FL 33440
Phone (800) 494-3984

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

280 Maple St
Ashland, OR 97520
Phone (541) 201-4000

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

Organizations & group practices 5

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": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1790910628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4749",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010227",
            "telephone_number": "541-789-4111",
            "fax_number": "541-789-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MAPLE STREET",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201552",
            "telephone_number": "541-201-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Lee Blvd",
            "address_purpose": "LOCATION",
            "city": "Lehigh Acres",
            "state": "FL",
            "postal_code": "339364835",
            "country_code": "US",
            "telephone_number": "239-369-2101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOROSH",
        "first_name": "JENNIFER",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301 094 181",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD201607",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME142519",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "56902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

Verify at the official NPI Registry.