Individual provider Active NPI

Clive Rosenbusch

  • Dentist
  • Boca Raton, FL
National Provider Identifier
1003210436
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN9306 Issued in FL
Practice address
2499 Glades Rd
Suite 307
Boca Raton, FL 33431-7202
Phone
(561) 394-7888
NPI assigned
Oct 14, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN9306 FL Primary

Addresses

Primary practice location

2499 Glades Rd
Suite 307
Boca Raton, FL 33431-7202

Mailing address

2499 Glades Rd
Suite 307
Boca Raton, FL 33431-7202
Phone (561) 394-7888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161028000437 FL Order and Referring Only - DentistPractitioner - Dentist 2769760602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clive Rosenbusch Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1003210436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2499 GLADES RD",
            "address_2": "SUITE 307",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317202",
            "telephone_number": "561-394-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2499 GLADES RD",
            "address_2": "SUITE 307",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317202",
            "telephone_number": "561-394-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBUSCH",
        "first_name": "CLIVE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN9306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.