Theresa E Ross

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

004876 Issued in NY

Practice address

410 Ditmas Ave
Brooklyn, NY 11218-4920

Phone

(718) 484-4878

NPI assigned

Jun 10, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Brooklyn Medical Practice PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1972967164
  NPD (past)

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1891362521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 DITMAS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184920",
            "telephone_number": "718-484-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 DITMAS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184920",
            "telephone_number": "718-484-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "THERESA",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "004876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://npiregistry.cams.hhs.gov/",
            "affiliation": "N",
            "endpointDescription": "URL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "410 Ditmas Ave",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112184920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rena Ross, NP
• Shaneka Ross, NP
• Susan Elizabeth Ross
• Suzette Ross, LCSW
• Tatyana Ross, LCSW, LMSW
• Tishawn Ross, MD
• Tricia Danielle Ross, MA, SLP-CCC
• Harvey S Rossel, DC
• Sharahn Danielle Rosser, RN
• Nechuma Rosset

• Physical Therapy Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.