Individual provider Active NPI

Juan C. Ross, MASSAJE THERAPIST

  • Massage Therapist
  • Miami, FL
National Provider Identifier
1982995817
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA62829 Issued in FL
Practice address
13549 SW 11TH LN
Miami, FL 33184-1837
Phone
(305) 303-2240
NPI assigned
Apr 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X HCC9395 FL
Massage Therapist 225700000X MA62829 FL Primary

Addresses

Primary practice location

13549 SW 11TH LN
Miami, FL 33184-1837

Mailing address

13549 SW 11TH LN
Miami, FL 33184-1837
Phone (305) 303-2240

Other practice location 1

4771 SW 8th St
Miami, FL 33134-2546
Phone (305) 646-1886

Other identifiers 1

IdentifierTypeStateIssuer
009966100MedicaidFL

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA62829FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
5D Community Group LLC Current Accepting new patients
Cybertalex Behavioral Center Corp CurrentSince Dec 6, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1982995817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13549 SW 11TH LN",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331841837",
            "telephone_number": "305-303-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13549 SW 11TH LN",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331841837",
            "telephone_number": "305-303-2240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4771 SW 8th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331342546",
            "country_code": "US",
            "telephone_number": "305-646-1886",
            "fax_number": "305-646-1887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JUAN",
        "middle_name": "C.",
        "credential": "MASSAJE THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-26",
        "last_updated": "2020-12-18",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "HCC9395",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA62829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009966100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.