Individual provider Active NPI

Alan Joseph Ross, MD

  • Internal Medicine Physician
  • Troy, MI
National Provider Identifier
1922008945
Registry record updated Jan 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301036707 Issued in MI
Practice address
750 Stephenson Hwy
235 BBC
Troy, MI 48083-1103
Phone
(248) 577-3522
Fax
(248) 577-3526
NPI assigned
Aug 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301036707 MI Primary

Addresses

Primary practice location

750 Stephenson Hwy
235 BBC
Troy, MI 48083-1103

Mailing address

29355 Northwestern Hwy
120
Southfield, MI 48034-1053
Phone (248) 577-3522

Other identifiers 1

IdentifierTypeStateIssuer
409812010MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301036707MIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263772800000",
    "number": "1922008945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29355 NORTHWESTERN HWY",
            "address_2": "120",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341053",
            "telephone_number": "248-577-3522",
            "fax_number": "248-577-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 STEPHENSON HWY",
            "address_2": "235 BBC",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831103",
            "telephone_number": "248-577-3522",
            "fax_number": "248-577-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "ALAN",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2010-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301036707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409812010",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; 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.