SUDEEP JABARAJ ROSS (NPI# 1821203589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821203589 |
| Entity Type | Individual |
| Full Name | SUDEEP JABARAJ ROSS |
| Credential | M.D. |
| Practice Address |
854 Route 212 Saugerties Wellness Center Saugerties NY 12477 |
| Mailing Address |
Po Box 14890 Sphpma Credentialing Albany NY 12212 |
| Practice Telephone | 8452462804 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2019-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 297063 | NY | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 297063 | NY | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | MT187011 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1821203589 | 05 | |
| NY | 05420228 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Tallow Wood Dr, Clifton Park, NY 120652807 | 5183734444 | |
| 2 Empire Dr Ste 101, Rensselaer, NY 121445730 | 5183734555 | |
| 377 Church St, Saratoga Springs, NY 128668641 | 5185844456 | 5185844476 |
| 400 Patroon Creek Blvd, Albany, NY 122065013 | 5184454444 | 5186181665 |
| 79 Vandenburgh Ave, Troy, NY 121806024 | 5182863000 |
| Street Address |
854 ROUTE 212 SAUGERTIES WELLNESS CENTER |
| City | SAUGERTIES |
| State | NY |
| Zip Code | 12477 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679576748 | Marie Patricia De La Parte | Nurse Practitioner | 854 Route 212, Saugerties, NY 12477-4619 | 2005-05-23 |
| 1417362963 | St. Peters Health Partners Medical Associates PC | Family Medicine | 854 Route 212, Saugerties, NY 12477-4619 | 2014-06-24 |
| 1780923029 | Health Quest Medical Practice | Internal Medicine | 854 Route 212, Saugerties, NY 12477 | 2013-02-06 |
| 1811163330 | Katherine Ellen Mahar | Nurse Practitioner | 854 Route 212, Saugerties, NY 12477-4619 | 2008-05-05 |
| 1295769818 | Ravi Ramaswami, Md PC | Family Medicine | 854 Route 212, Saugerties, NY 12477-4619 | 2006-07-10 |
| 1467401364 | Cardiology Consultants of Westchester | Internal Medicine | 854 Route 212, Saugerties, NY 12477 | 2006-05-08 |
| 1902891930 | Olin P Callaghan | Physician Assistant | 854 Route 212, Saugerties, NY 12477 | 2005-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437611316 | Laurie J. Fischer | Licensed Practical Nurse | 32a Fortune Valley Ln, Saugherties, NY 12477 | 2019-04-01 |
| 1407315385 | Justin D Gray | Licensed Practical Nurse | 32 B Fortune Valley Lane, Saugerties, NY 12477 | 2019-03-19 |
| 1780166645 | Open Door Family Medical Center Inc | Clinic/Center | 16 W Bridge St Ste 4, Saugerties, NY 12477 | 2018-09-06 |
| 1609374503 | Rachel Caroline Brousseau | Physician Assistant | 2976 Us-9w, Saugerties, NY 12477 | 2018-01-25 |
| 1982145124 | Jacqueline Paunovic | Massage Therapist | 175 North Drive, Saugeties, NY 12477 | 2017-03-20 |
| 1902236201 | Brenda Belle-dunmore | Licensed Practical Nurse | 2683 Route 9w, Saugerties, NY 12477 | 2013-11-22 |
| 1780957811 | Deborah Anne Dickson | Registered Nurse | 10 John Yaeger Rd, Saugerties, NY 12477 | 2012-02-21 |
| 1225348907 | Jeane Catherine Mcmahon | Registered Nurse | 20 Leonard La, Saugerties, NY 12477 | 2010-10-15 |
| 1902116593 | Patricia Fricker | Registered Nurse | 39 Diamond Court, Saugerties, NY 12477 | 2010-10-15 |
| 1619285657 | Jay E. Brown | Psychologist | 310 Washington Avenue, Call Box A, Saugerties, NY 12477 | 2010-09-23 |
| Find all providers in zip 12477 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245599877 | Hurley Avenue Family Medicine | Family Medicine | 3190 Route 9w, Saugerties, NY 12477-5212 | 2012-05-16 |
| 1649273202 | Laura J Decker | Family Medicine | 16 W Bridge St, Saugerties, NY 12477-1415 | 2005-05-27 |
| 1487657045 | Eugene P Heslin | Family Medicine | 16 West Bridge St, Saugerties, NY 12477 | 2005-05-27 |
| 1154588713 | Soe P. Kyaw | Family Medicine | 16 W Bridge St, Suite # 1, Saugerties, NY 12477-1427 | 2008-05-21 |
| 1710990999 | Eugene P Heslin Md PC | Family Medicine | 16 W Bridge St, Saugerties, NY 12477-1415 | 2006-08-15 |
| 1295769818 | Ravi Ramaswami, Md PC | Family Medicine | 854 Route 212, Saugerties, NY 12477-4619 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295558 | Mamoon Malik | Family Medicine | 90 Menands Rd, Albany, NY 12204-1400 | 2020-11-08 |
| 1336749571 | Chowdhury Medical PC | Family Medicine | 155 Alkier St, Brentwood, NY 11717-5129 | 2020-10-27 |
| 1356940084 | Rebecca Jean Smouse | Family Medicine | 1107 Prendergast Ave, Jamestown, NY 14701-3315 | 2020-10-23 |
| 1336748136 | Rapha House Calls | Family Medicine | 2 Fernglade Ct, Chester, NY 10918-2637 | 2020-10-22 |
| 1174122980 | Richmond Health Partners Ipa LLC | Family Medicine | 1161 Victory Blvd, Staten Island, NY 10301-3621 | 2020-10-22 |
| 1730787128 | Michael C Secallus | Family Medicine | 66 Kirkwood Gdns, Kirkwood, NY 13795-1623 | 2020-10-16 |
| 1861099053 | Julia Gross Family Health Nurse Practitioner, Pllc | Family Medicine | 950 Route 146 Ste 100, Clifton Park, NY 12065-3667 | 2020-10-01 |
| 1013523190 | Steinway Hope Medical LLC | Family Medicine | 8829 54th Ave Fl 2, Elmhurst, NY 11373-4543 | 2020-09-23 |
| 1538774500 | Jenny Brandt | Family Medicine | 3048 Sunset Ln # 2, Schenectady, NY 12303-5528 | 2020-09-15 |
| 1992319016 | Sarah Glaser | Family Medicine | 30 W 24th St, New York, NY 10010-3207 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | SAUGERTIES |
| Zip Code | 12477 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.