DR. THEODORE ROSS MD
NPI 1285720508
Internal Medicine in Kissimmee, FL

Active since October 05, 2006PECOS EnrolledAccepts Medicare Assignment
109 N DOVERPLUM AVE, KISSIMMEE, FL 34758(407) 943-8600(833) 464-3641 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 5, 2026, Jul 11, 2025, May 24, 2021 (3 updates tracked since 2021).

About Dr. Theodore Ross Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THEODORE ROSS MD (NPI 1285720508) is an individual internal medicine provider in Kissimmee, Florida, licensed in Florida (ME179187) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Touchette Regional Hospital Inc, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1285720508
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. THEODORE ROSSCredential: MD
Location Address109 N DOVERPLUM AVEKissimmee, FL 34758-3309
Mailing Address1503 Bill Beck BlvdKissimmee, FL 34744-9516 · (407) 943-8600 · Fax (407) 932-5150
Fax(833) 464-3641
Sole ProprietorNo
Medical School CMSWashington University School Of MedicineGraduated 1984
Enumeration DateOctober 5, 2006
Last NPPES UpdateMay 5, 20263 updates tracked since enumeration
NPPES CertifiedMay 5, 2026
NPI 1285720508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses Licensed in FL · ME179187 Licensed in IL · 036075238
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
109 N DOVERPLUM AVE, Kissimmee, FL 34758

Secondary Practice Locations 2

Location 16010 Bond AveEast Saint Louis, IL 62207-2328 · Phone (618) 337-8153 · Fax (618) 337-8905
Location 22166 Madison AveGranite City, IL 62040-4700 · Phone (618) 452-3301 · Fax (618) 452-3112

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Theodore Ross Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971693813
PECOS Enrollment IDI20260522000472
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Touchette Regional Hospital Inc

Acute Care Hospitals · Centreville, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number140077
Location5900 Bond AvenueCentreville, IL 62207 · St. Clair County
Emergency services

Gateway Regional Medical Center

Acute Care Hospitals · Granite City, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140125
Location2100 Madison AvenueGranite City, IL 62040 · Madison County
Emergency services

Memorial Hospital

Acute Care Hospitals · Belleville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140185
Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County
Emergency services Birthing friendly

Missouri Baptist Medical Center

Acute Care Hospitals · Town And Country, MO
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260108
Location3015 N Ballas RdTown And Country, MO 63131 · St. Louis County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34758 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
49%797 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
21%280 patients1/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
94%6,550 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
18%446 patients1/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%497 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
81%1,999 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
80%1,956 patients4/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
94%1,999 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
18%1,999 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
22%1,999 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers13 claims42 services$5.65 avg. paid by Medicare
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each A4388
DME-Orthotic Devices · category DF010N
1 supplier11 claims220 services$4.22 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers18 claims18 services$31.41 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier18 claims18 services$2.66 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$70.05 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

General Practice
109 N DOVERPLUM AVE
KISSIMMEE, FL 34758
Dentist (General Practice)
109 N DOVERPLUM AVE
KISSIMMEE, FL 34758
General Practice
109 N DOVERPLUM AVE
KISSIMMEE, FL 34758
Pharmacy (Clinic Pharmacy)
109 N DOVERPLUM AVE
KISSIMMEE, FL 34758
Nurse Practitioner (Family)
109 N DOVERPLUM AVE
KISSIMMEE, FL 34758
Pediatrics
109 N DOVERPLUM AVE
KISSIMMEE, FL 34758
Counselor (Mental Health)
109 N DOVERPLUM AVE
KISSIMMEE, FL 34758
Nurse Practitioner (Family)
109 N DOVERPLUM AVE
KISSIMMEE, FL 34758

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Ross's NPI number?

The NPI number for Theodore Ross is 1285720508. It was assigned to this individual provider in the NPPES registry on October 5, 2006.

Where is Theodore Ross located?

Theodore Ross practices at 109 N Doverplum Ave, Kissimmee, FL 34758. The listed phone number is (407) 943-8600.

What is Theodore Ross's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Theodore Ross enrolled in Medicare?

Yes. Theodore Ross is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Theodore Ross accept?

Health plans from UnitedHealthcare list Theodore Ross as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Theodore Ross affiliated with any hospitals?

According to CMS data, Theodore Ross is affiliated with Touchette Regional Hospital Inc, Gateway Regional Medical Center, Memorial Hospital and Missouri Baptist Medical Center.

When was this NPI record last updated?

The NPPES record for Theodore Ross was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.