Active NPI
Ellen Ross, PA-C
- Physician Assistant
- Berlin, NH
National Provider Identifier
1972505733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0317P
- Practice address
- 59 Page Hill Rd
Berlin, NH 03570-3531 - Phone
- (603) 752-2900
- Fax
- (603) 752-3727
- NPI assigned
- Aug 11, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0317P | NH | Primary |
Addresses
Primary practice location
59 Page Hill Rd
Berlin, NH 03570-3531
Mailing address
133 Pleasant St
Berlin, NH 03570-2006
Phone (603) 752-2040
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5830418 | Other | AETNA GROUP | |
| 30330328 | Medicaid | NH | |
| P00100698 | Other | RAILROAD MEDICARE | |
| 0317P | Other | NH | STATE LICENSE # |
| 0109410YPNH02 | Other | NH | ANTHEM BC/BS |
| 3071702 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040525000568 | NH | Practitioner - Physician Assistant | 6901887280 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0317P | NH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coos County Family Health Services, Inc. | Past | Accepting new patients |
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.
-
- Federally Qualified Health Center (FQHC)
- Berlin, NH
- NPI 1427050012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1972505733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 PLEASANT ST",
"city": "BERLIN",
"state": "NH",
"postal_code": "035702006",
"telephone_number": "603-752-2040",
"fax_number": "603-752-1709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 PAGE HILL RD",
"city": "BERLIN",
"state": "NH",
"postal_code": "035703531",
"telephone_number": "603-752-2900",
"fax_number": "603-752-3727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "ELLEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-11",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NH",
"license": "0317P",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA GROUP",
"identifier": "5830418",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30330328",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00100698",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE #",
"identifier": "0317P",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "0109410YPNH02",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3071702",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Berlin, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.