Individual provider Active NPI

Katherine Gloria Ross

  • Student in an Organized Health Care Education/Training Program
  • Long Beach, CA
National Provider Identifier
1891282141
Registry record updated Apr 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
5901 E 7TH St
Long Beach, CA 90822-5201
Phone
(562) 826-8000
NPI assigned
Apr 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

5901 E 7TH St
Long Beach, CA 90822-5201

Mailing address

15 Warford Ter
Orinda, CA 94563-2811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201118002905 OR Practitioner - Optometry 3476987033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myoptic Optometry, LLCGroup PAC ID 4183719701, 6 clinicians

Practice addresses (Care Compare)

3978 N Williams Ave
Portland, OR 97227-1445
Phone (503) 493-7070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4531ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myoptic Optometry, LLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

8046 SE 13th Ave
Portland, OR 97202
Phone (503) 420-8689

3978 N Williams Ave
Portland, OR 97227
Phone (503) 493-7070

12 SE 28th Ave
Portland, OR 97214
Phone (503) 282-2020

Organizations & group practices 1

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": "1524268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524268800000",
    "number": "1891282141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WARFORD TER",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 E 7TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908225201",
            "telephone_number": "562-826-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KATHERINE",
        "middle_name": "GLORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-21",
        "last_updated": "2018-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.