NPIMap

Organization Active NPI

Rosenberg Center Assessment and Treatment for Children & Families PA

  • Developmental Disabilities Clinic/Center
  • Roseville, MN
National Provider Identifier
1033347331
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
License
7340 Issued in MN
Legal business name
ROSENBERG CENTER ASSESSMENT AND TREATMENT FOR CHILDREN & FAMILIES PA
Practice address
1935 Country Road B2 West
Suite 100
Roseville, MN 55113
Phone
(651) 636-4155
Fax
(651) 636-3595
NPI assigned
Jun 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Authorized official

Name
Mae G Petrangelo, MS, CCC-SLP
Title
Speech-Language Pathologist
Phone
(651) 636-4155

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X 7340 MN Primary
Developmental Disabilities Clinic/Center 261QD1600X 7109 MN

Addresses

Primary practice location

1935 Country Road B2 West
Suite 100
Roseville, MN 55113

Mailing address

1935 Country Road B2 West
Suite 100
Roseville, MN 55113
Phone (651) 636-4155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160418001647 MN Part B Supplier - Clinic/Group Practice 0749596658 Receives reassigned benefits from 2 practitioners
Practice locations: Roseville, MN

National Provider Directory

National Provider Directory
Tax ID family
Rosenberg Center Assessment and Treatmen2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12400 Portland Ave
Ste 180
Burnsville, MN 55337
Phone (952) 405-9601

5500 Wayzata Blvd
Ste 510
Minneapolis, MN 55416

4510 77th St W
Minneapolis, MN 55435
Phone (952) 230-9100

1935 County Road B2 W
Ste 100
Saint Paul, MN 55113
Phone (651) 636-4155

1935 County Road B2 W
Saint Paul, MN 55113
Phone (612) 504-7903

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1033347331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 COUNTRY ROAD B2 WEST",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-636-4155",
            "fax_number": "651-636-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 COUNTRY ROAD B2 WEST",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-636-4155",
            "fax_number": "651-636-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSENBERG CENTER ASSESSMENT AND TREATMENT FOR CHILDREN & FAMILIES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-24",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "PETRANGELO",
        "authorized_official_first_name": "MAE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "651-636-4155",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "MN",
            "license": "7340",
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "MN",
            "license": "7109",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.