Individual provider Active NPI

Mindy K Ross, M.D.

  • Pediatric Pulmonology Physician
  • Los Angeles, CA
National Provider Identifier
1861628828
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
A99914 Issued in CA
Practice address
10833 Le Conte Ave
MDCC 22-387
Los Angeles, CA 90095
Phone
(310) 825-5930
Fax
(310) 794-7338
NPI assigned
Jun 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A99914 CA
Pediatric Pulmonology Physician 2080P0214X A99914 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
MDCC 22-387
Los Angeles, CA 90095

Mailing address

10833 Le Conte Ave
MDCC 22-387
Los Angeles, CA 90095
Phone (310) 825-5930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090728000775 CA Practitioner - Pediatric Medicine 3577616291 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A99914CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Pediatrics CurrentSince Aug 1, 2015 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
The Regents of the University of California Past Accepting new patients
UCLA Medical Group Pediatrics Past Accepting new patients

Locations

200 UCLA Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-2429

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

757 Westwood Plz
Fl 5
Los Angeles, CA 90095
Phone (310) 267-7565

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

10833 Le Conte Ave
#22387
Los Angeles, CA 90095
Phone (310) 825-5930

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

1260 15th St
Ste 1024
Santa Monica, CA 90404
Phone (424) 259-8570

Interoperability endpoints

  • Direct secure messaging: mross408751@direct.uclahealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1861628828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "MDCC 22-387",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90095",
            "telephone_number": "310-825-5930",
            "fax_number": "310-794-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "MDCC 22-387",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90095",
            "telephone_number": "310-825-5930",
            "fax_number": "310-794-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "MINDY",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A99914",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CA",
            "license": "A99914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.