Individual provider Active NPI

Martin G. Rosen, D.C.

  • Chiropractor
  • Wellesley, MA
National Provider Identifier
1003905274
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
664 Issued in MA
Practice address
471 Washington St
Wellesley, MA 02482-5935
Phone
(781) 237-6673
Fax
(781) 996-4347
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 664 MA Primary

Addresses

Primary practice location

471 Washington St
Wellesley, MA 02482-5935

Mailing address

471 Washington St
Wellesley, MA 02482-5935
Phone (781) 237-6673

Other identifiers 2

IdentifierTypeStateIssuer
1612875MedicaidMA
Y35460OtherMABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060501000210 MA Practitioner - Chiropractic 4486664893 Practice locations: Wellesley, MA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

471 Washington St
Wellesley, MA 02482-5935
Phone (781) 237-6673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
664MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellesley Chiropractic Office Chiropractor 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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1003905274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 WASHINGTON ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024825935",
            "telephone_number": "781-237-6673",
            "fax_number": "781-996-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 WASHINGTON ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024825935",
            "telephone_number": "781-237-6673",
            "fax_number": "781-996-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "MARTIN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1612875",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y35460",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.