| Sudeep Jabaraj Ross, MD | |
|
854 Route 212, Saugerties Wellness Center, Saugerties, NY 12477 | |
| (845) 246-2804 | |
| Not Available |
| Full Name | Sudeep Jabaraj Ross |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 854 Route 212, Saugerties, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821203589 | NPI | - | NPPES |
| 05420228 | Medicaid | NY | |
| 1821203589 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 297063 (New York) | Secondary |
| 207Q00000X | Family Medicine | MT187011 (Pennsylvania) | Secondary |
| 207Q00000X | Family Medicine | 297063 (New York) | Primary |
| Entity Name | Samaritan Hospital Of Troy, New York |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043267727 PECOS PAC ID: 6507770070 Enrollment ID: O20031118000782 |
| Entity Name | Oldendorf Medical Services Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518107069 PECOS PAC ID: 3274684949 Enrollment ID: O20090622000002 |
| Entity Name | St. Peter's Health Partners Medical Associates, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750626834 PECOS PAC ID: 6103061189 Enrollment ID: O20130321000567 |
| Mailing Address | Practice Location Address |
|---|---|
| Sudeep Jabaraj Ross, MD Po Box 14890, Sphpma Credentialing, Albany, NY 12212 Ph: () - | Sudeep Jabaraj Ross, MD 854 Route 212, Saugerties Wellness Center, Saugerties, NY 12477 Ph: (845) 246-2804 |
Anna Nikolaevna Samedova, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 854 Route 212, Saugerties Wellness Center, Saugerties, NY 12477 Phone: 845-246-2804 | |
Dr. Soe P. Kyaw, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 16 W Bridge St, Suite # 1, Saugerties, NY 12477 Phone: 845-246-3000 Fax: 845-246-7622 | |
Dr. Eugene P Heslin, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 16 West Bridge St, Saugerties, NY 12477 Phone: 845-246-3000 Fax: 845-246-7622 | |
Dr. Laura J Decker, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 16 W Bridge St, Saugerties, NY 12477 Phone: 845-246-3000 Fax: 845-246-7622 | |
Yvenalie Laurent, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 854 Route 212, Saugerties, NY 12477 Phone: 845-246-2804 |