NPIMap

Individual provider Active NPI

Justin Meir Ross, DO

  • Emergency Medicine Physician
  • Fort Carson, CO
National Provider Identifier
1861889081
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0063031 Issued in CO
Practice address
1650 Cochrane Cir Dept of
Ft Carson, CO 80913
Phone
(719) 524-7111
NPI assigned
Apr 26, 2015
Last updated
Jan 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0063031 CO Primary
Military Health Care Provider 171000000X NU

Addresses

Primary practice location

1650 Cochrane Cir Dept of
Ft Carson, CO 80913

Mailing address

1650 Cochrane Cir Dept of
Ft Carson, CO 80913-4613
Phone (719) 524-7111

Other practice location 1

3551 Roger Brooke Dr
Dept of Emergency Medicine
San Antonio, TX 78234
Phone (210) 916-2500

Other practice location 2

400 W 16th St
Pueblo, CO 81003-2781
Phone (719) 584-4306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200127001922 CO Practitioner - Emergency Medicine 2264867910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.65 of 100Reported as group
Quality
64.78
Improvement activities
40
Cost
70.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0063031COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Colorado Emergency Medical Associates Single Specialty CurrentSince Apr 1, 2025 Accepting new patients
Southern Colorado Emergency Medical Associates Emergency Medicine CurrentSince Apr 1, 2025 Accepting new patients

Locations

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

899 E Industrial Blvd
Pueblo West, CO 81007
Phone (719) 288-2100

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1861889081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR DEPT OF",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "719-524-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR DEPT OF",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "80913",
            "telephone_number": "719-524-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_2": "Dept of Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78234",
            "country_code": "US",
            "telephone_number": "210-916-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W 16th St",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810032781",
            "country_code": "US",
            "telephone_number": "719-584-4306",
            "fax_number": "719-595-7886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JUSTIN",
        "middle_name": "MEIR",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-26",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "0063031",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Carson, CO

Sources for this page

Verify at the official NPI Registry.