Individual provider Active NPI

Kathryn A Ross, M.D.

  • Gastroenterology Physician
  • Newport Beach, CA
National Provider Identifier
1871537035
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G42979 Issued in CA
Practice address
901 Dover Dr
Suite 122
Newport Beach, CA 92660-5538
Phone
(949) 650-8700
Fax
(949) 650-0877
NPI assigned
Jun 16, 2006
Last updated
Aug 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G42979 CA Primary

Addresses

Primary practice location

901 Dover Dr
Suite 122
Newport Beach, CA 92660-5538

Mailing address

901 Dover Dr
Suite 122
Newport Beach, CA 92660-5538
Phone (949) 650-8700

Other identifiers 2

IdentifierTypeStateIssuer
00G429790MedicaidCA
WG42979BOtherMEDICARE PTAN

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
I20100909001055 CA Practitioner - Gastroenterology 2365567674 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Doctors CurrentSince Jan 1, 2016 Accepting new patients
United Medical Doctors Gastroenterology CurrentSince Jan 1, 2016 Accepting new patients
Gastroenterology Alliance of Newport, a Medical Partnership Gastroenterology PastSince Jun 15, 2001 Accepting new patients
Laguna Aesthetics & Family Wellness Center, Inc Past Accepting new patients

Locations

2083 Compton Ave
Ste 104
Corona, CA 92881
Phone (951) 256-8191

521 E Elder St
Ste 104
Fallbrook, CA 92028
Phone (760) 728-9560

400 Newport Center Dr
Ste 609
Newport Beach, CA 92660
Phone (949) 760-0398

901 Dover Dr
Ste 122
Newport Beach, CA 92660
Phone (949) 574-9390

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9170/brand/1/csg/1/fhir/r4

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1871537035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 DOVER DR",
            "address_2": "SUITE 122",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605538",
            "telephone_number": "949-650-8700",
            "fax_number": "949-650-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DOVER DR",
            "address_2": "SUITE 122",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605538",
            "telephone_number": "949-650-8700",
            "fax_number": "949-650-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G42979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G429790",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WG42979B",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.