JOHNNY SHANE ROSS M.D.
NPI 1104935030
Physical Medicine & Rehabilitation in Temple, TX

NPI Status: Active since August 30, 2006

Contact Information

2401 S 31ST ST BLDG 35
TEMPLE, TX
ZIP 76508
Phone: (254) 724-2111
Fax: (512) 263-4506

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  • Individual
  • Male
  • Years of Experience 33
  • Physical Medicine & Rehabilitation
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About JOHNNY ROSS

This page provides the complete NPI Profile along with additional information for Johnny Ross, a provider established in Temple, Texas with a medical specialization in Physical Medicine & Rehabilitation and more than 33 years of experience. He graduated from University Of Texas Medical School At Houston in 1993. The healthcare provider is registered in the NPI registry with number 1104935030 assigned on August 2006. The practitioner's primary taxonomy code is 208100000X with license number J6036 (TX). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1104935030
Provider Name
JOHNNY SHANE ROSS M.D.
Gender
Male
Entity Type
Individual
Location Address
2401 S 31ST ST BLDG 35 TEMPLE, TX 76508
Location Phone
(254) 724-2111
Location Fax
(512) 263-4506
Mailing Address
PO BOX 844658 DALLAS, TX 75284
Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduation Year
1993
Is Sole Proprietor?
No
Enumeration Date
08-30-2006
Last Update Date
10-23-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Medicine & Rehabilitation

Taxonomy Code
208100000X
Type
Allopathic & Osteopathic Physicians
License No.
J6036
License State
TX
Taxonomy Description
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BSW Diabetes Care Gold HMO 014 - HMO
  • BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Elite Gold HMO 004 - HMO
  • BSW Elite Gold HMO 012 - HMO
  • BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Prime Silver HMO 008 - HMO
  • BSW Prime Silver HMO 005 - HMO
  • BSW Savers Bronze HMO H S A 006 - HMO
  • BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Savers Bronze HMO H S A 009 - HMO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • MyBlue Health Bronze? 402 - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
0479743 02MEDICAID (05)TX 
J6036OTHER (01)TXTX LICENSURE MEDICAL BOARD
142726600OTHER (01)US DEPARTMENT OF LABOR

Medicare Participation & PECOS Enrollment Status

Johnny Ross is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Johnny Ross is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 5193710143

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20141007002261

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE000N)

    Walker, folding, wheeled, adjustable or fixed height (HCPCS:E0143)

    2 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    3 DME suppliers used 37 Medicare Claims 37 Services Paid

  • DME-Wheelchairs (DD021N)

    Manual wheelchair accessory, anti-tipping device, each (HCPCS:E0971)

    1 DME suppliers used 14 Medicare Claims 28 Services Paid

  • DME-Wheelchairs (DD021N)

    Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each (HCPCS:E0973)

    1 DME suppliers used 13 Medicare Claims 26 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    6 DME suppliers used 123 Medicare Claims 123 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    2 DME suppliers used 32 Medicare Claims 32 Services Paid

  • DME-Wheelchairs (DD021N)

    General use wheelchair seat cushion, width less than 22 inches, any depth (HCPCS:E2601)

    1 DME suppliers used 15 Medicare Claims 15 Services Paid

  • DME-Wheelchairs (DD021N)

    General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware (HCPCS:E2611)

    1 DME suppliers used 14 Medicare Claims 14 Services Paid

  • DME-Wheelchairs (DD000N)

    Standard wheelchair (HCPCS:K0001)

    4 DME suppliers used 59 Medicare Claims 59 Services Paid

  • DME-Wheelchairs (DD000N)

    Lightweight wheelchair (HCPCS:K0003)

    5 DME suppliers used 170 Medicare Claims 170 Services Paid

  • DME-Wheelchairs (DD021N)

    Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)

    4 DME suppliers used 39 Medicare Claims 39 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 398 times for 51 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 59 times for 52 patients

Hospital discharge day management, 30 minutes or less

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

This service was performed 53 times for 52 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 46 times for 45 patients

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Use of QCDR data for quality improvement such as comparative analysis reports across patient populationsYesN/A
Participation in a QCDR, clinical data registries, or other registries run by other government agencies such as FDA, or private entities such as a hospital or medical or surgical society. Activity must include use of QCDR data for quality improvement (e.g., comparative analysis across specific patient populations for adverse outcomes after an outpatient surgical procedure and corrective steps to address adverse outcome).

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Johnny Ross is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE2401 S 31ST ST
TEMPLE, TX 76508
(254) 724-2111Acute Care Hospitals
ADVENTHEALTH CENTRAL TEXAS2201 S CLEAR CREEK ROAD
KILLEEN, TX 76542
(254) 526-7523Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1104935030, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
3
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
0
Unchanged
Pos 9
3
Doubled → 6
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 9 → 18 → 9 5 → 10 → 1 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 0 + 4 + 1 + 8 + 3 + 1 + 0 + 0 + 6 + 24 = 50

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 50 is 50. The difference is the calculated check digit.

50 - 50 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1104935030.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Physician Assistant (Surgical)
2401 S 31ST ST BLDG 35
TEMPLE, TX 76508
Physician Assistant
2401 S 31ST ST BLDG 35
TEMPLE, TX 76508
Orthopaedic Surgery (Hand Surgery)
2401 S 31ST ST BLDG 35
TEMPLE, TX 76508
Orthopaedic Surgery (Pediatric Orthopaedic Surgery)
2401 S 31ST ST BLDG 35
TEMPLE, TX 76508
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
2401 S 31ST ST BLDG 35
TEMPLE, TX 76508
Nurse Practitioner
2401 S 31ST ST BLDG 35
TEMPLE, TX 76508
Physician Assistant
2401 S 31ST ST BLDG 35
TEMPLE, TX 76508

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104935030, enumerated as an "individual" on August 30, 2006.

The provider is located at 2401 S 31ST ST BLDG 35 TEMPLE, TX 76508 and the phone number is (254) 724-2111.

Physical Medicine & Rehabilitation with taxonomy code 208100000X.

The provider might be accepting Accepts: Baylor Scott and White Health Plan, Blue Cross and. Please consult your insurance carrier or call the provider to verify.

Johnny Ross is affiliated with: BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE and ADVENTHEALTH CENTRAL TEXAS.