Individual provider Active NPI

Samuel C Rossi, M.D.

  • Surgery Physician
  • Charleston, WV
National Provider Identifier
1952497703
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
21558 Issued in WV
Practice address
600 Tracy Way
Suite 2
Charleston, WV 25311-1262
Phone
(304) 388-4965
Fax
(304) 388-4968
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 21558 WV Primary

Addresses

Primary practice location

600 Tracy Way
Suite 2
Charleston, WV 25311-1262

Mailing address

600 Tracy Way
Ste 2
Charleston, WV 25311-1262
Phone (304) 388-1724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20050722000002 WV Practitioner - General Surgery 8426096603 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21558WVMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Mar 7, 2016 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Mar 7, 2016 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

415 Morris St
Ste 309
Charleston, WV 25301
Phone (304) 348-3290

3100 Maccorkle Ave SE
Ste 203
Charleston, WV 25304
Phone (304) 345-8820

3200 Maccorkle Ave SE
#C
Charleston, WV 25304
Phone (304) 347-1336

600 Tracy Way
Ste 2
Charleston, WV 25311
Phone (304) 388-4965

3703 Teays Valley Rd
Hurricane, WV 25526
Phone (304) 757-2273

Organizations & group practices 4

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1952497703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 TRACY WAY",
            "address_2": "STE 2",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111262",
            "telephone_number": "304-388-1724",
            "fax_number": "304-388-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 TRACY WAY",
            "address_2": "SUITE 2",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111262",
            "telephone_number": "304-388-4965",
            "fax_number": "304-388-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSI",
        "first_name": "SAMUEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "21558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.