Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Robert Ross

Individual provider Physician Assistant · NPI 1104180074

Robert Ross is a Physician Assistant in Montoursville, Pennsylvania. Qualified in 2012, 14 years ago. Practices with Susquehanna Physician Services, a 612-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
14
Licensed in
PA
In the registry since
2012

Practice location Address checks out

780 Broad St Ste 4
Montoursville, PA 17754-2419
Phone: (570) 368-2870
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA055521 (PA)

Record details

NPI number1104180074
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 26, 2012
Last updated in NPPESJune 15, 2021
Mailing address100 N Academy Ave, Credentials Dept, Danville, PA 17822-4903

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Susquehanna Physician Services — 612 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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