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MR. NATHANIEL T ROSS MD
NPI 1417942707
Family Medicine in Gary, IN

Active since September 13, 2005PECOS EnrolledAccepts Medicare Assignment
97.09/100
CMS Quality Rating
1619 W 5TH AVE, GARY, IN 46404(219) 886-4788(219) 886-4106 Get Directions Write a Review

NPPES record last updated: April 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Nathaniel T Ross Md NPPES

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

MR. NATHANIEL T ROSS MD (NPI 1417942707) is an individual family medicine provider in Gary, Indiana, licensed in Indiana (01052287) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Methodist Hospitals Inc, and is a graduate of Indiana University School Of Medicine (1997).

NPPES Registry Identity

NPI1417942707
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMR. NATHANIEL T ROSSCredential: MD
Location Address1619 W 5TH AVEGary, IN 46404-1506
Mailing AddressPo Box 4787Gary, IN 46404-0787 · (219) 886-4788 · Fax (219) 886-4106
Phone(219) 886-4788
Fax(219) 886-4106
Sole ProprietorYes
Medical School CMSIndiana University School Of MedicineGraduated 1997
Enumeration DateSeptember 13, 2005
Last NPPES UpdateApril 8, 2025
NPPES CertifiedApril 8, 2025
✔ NPI 1417942707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 01052287
Definition
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.
1619 W 5TH AVE, Gary, IN 46404
Open in Google Maps ↗

Other Identifiers 2

Other080179270GA · Medicare Railroad
Medicaid200353510AIN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Mr. Nathaniel T 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 ID6709808264
PECOS Enrollment IDI20060119000500
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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
333 services85 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
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.
112 services18 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
87 services12 patients
Hospital discharge day management, 30 minutes or less 99238
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.
41 services25 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
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.
30 services20 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
24 services24 patients

Hospital Affiliations CMS Care Compare

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

Methodist Hospitals Inc

Acute Care Hospitals · Gary, IN
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150002
Location600 Grant StGary, IN 46402 · Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46404 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

97.09/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality94.99
Improvement Activities40
Cost80.3

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
8 suppliers35 claims99 services$6.14 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers14 claims26 services$1.06 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$14.81 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 supplier20 claims20 services$65.44 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
5 suppliers20 claims20 services$24.72 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 5

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

EDWARD B ZIESMER PT MS
Physical Therapist
1619 W 5TH AVE
GARY, IN 46404
Lake County (219) 886-4788
5TH AVE DENTAL INC.
Dentist (General Practice)
1619 W 5TH AVE
GARY, IN 46404
Lake County (708) 359-2068
DAVID E ROSS, JR, MD,PC
Family Medicine
1619 W 5TH AVE
GARY, IN 46404
Lake County (219) 886-4788
MS. RACHAEL L ROSS MD
Family Medicine
1619 W 5TH AVE
GARY, IN 46404
Lake County (219) 886-4788
MS. LOLITA IZETT HARMON FNP-BC
Nurse Practitioner (Family)
1619 W 5TH AVE
GARY, IN 46404
Lake County (219) 886-4788

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 Nathaniel Ross's NPI number?

The NPI number for Nathaniel Ross is 1417942707. It was assigned to this individual provider in the NPPES registry on September 13, 2005.

Where is Nathaniel Ross located?

Nathaniel Ross practices at 1619 W 5th Ave, Gary, IN 46404. The listed phone number is (219) 886-4788.

What is Nathaniel Ross's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Nathaniel Ross enrolled in Medicare?

Yes. Nathaniel 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 Nathaniel Ross accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Nathaniel 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 Nathaniel Ross affiliated with any hospitals?

According to CMS data, Nathaniel Ross is affiliated with Methodist Hospitals Inc.

When was this NPI record last updated?

The NPPES record for Nathaniel Ross was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.