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Deactivated NPI 1013082015 Deactivated / Inactive NPI Male Practitioner

Shawn Patrick Ross , PA

Physician Assistant • Newark, NY

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Shawn Ross has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 22, 2006
NPI Deactivation Date September 27, 2018
Total Practice Duration ~12 Years of Practice (2006 – 2018)

Professional Overview & Biography Verified Profile Summary

Shawn Ross, PA was a registered Physician Assistant practicing in Newark, NY. Throughout an active medical career spanning 12 years, Shawn Ross provided care at the practice location at 111 DRIVING PARK AVE until profile deactivation on 2018-09-27.

Practice Location & Contact Primary Location

Practice Address

111 Driving Park Ave

Newark, NY 145131066

Telephone 3153322424
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Newark, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.4 Yrs
State Avg: 12.0 Yrs
Regional Practice Density
18 Specialists

Practicing in Newark, NY (15701 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License NY 011353

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1720015480

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 27, 2018

Record deactivated on September 27, 2018

NPI Profile Active November 22, 2011

NPI status registered as active in NPPES database

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Updated Practice Location November 22, 2011

Registered at 111 DRIVING PARK AVE, NEWARK, NY 145131066 (Tel: 3153322424)

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Updated Business Mailing Address November 22, 2011

Registered at 1200 DRIVING PARK AVE, NEWARK, NY 145131057 (Tel: 5857043886)

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Provider Name / Credentials Updated November 22, 2011

Recorded as SHAWN ROSS, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 22, 2011

Physician Assistant (License #011353 in NY)

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Initial NPI Registration & Enumeration November 22, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1013082015
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 22, 2006
Last Update: November 22, 2011
Deactivation Date: September 27, 2018

Mailing Address

1200 Driving Park Ave

Newark, NY 145131057

Phone: 5857043886

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.