Active NPI
Douglas Augustus Ross, MD
- Otolaryngology Physician
- Tampa, FL
National Provider Identifier
1912988692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- ME 120665
- Practice address
- 3100 E Fletcher Ave
Tampa, FL 33613-4613 - Phone
- (813) 615-7200
- NPI assigned
- Nov 9, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 033354 | CT | |
| Otolaryngology Physician | 207Y00000X | ME 120665 | FL | Primary |
Addresses
Primary practice location
3100 E Fletcher Ave
Tampa, FL 33613-4613
Mailing address
5151 N 9TH Ave
Pensacola, FL 32504-8721
Phone (850) 416-2928
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001333541 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141203002498 | FL | Practitioner - Otolaryngology | 0547317836 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033354 | CT | MD | Otolaryngology Physician |
| ME 120665 | FL | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sacred Heart Health System, Inc. | Current | Accepting new patients | |
| Neighborhood Health, Inc. | Otolaryngology | Past | Accepting new patients |
Locations
5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700
Interoperability endpoints
- douglas.ross.1@9582.direct.athenahealth.com
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 and National Provider Directory roles.
-
- Ambulatory Family Planning Facility
- Pensacola, FL
- NPI 1962453308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1912988692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5151 N 9TH AVE",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325048721",
"telephone_number": "850-416-2928",
"fax_number": "850-416-6119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 E FLETCHER AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336134613",
"telephone_number": "813-615-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "DOUGLAS",
"middle_name": "AUGUSTUS",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-09",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CT",
"license": "033354",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "FL",
"license": "ME 120665",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001333541",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.