Active NPI
Cesar Jose Rosa, D.O.
- Gastroenterology Physician
- Joint Base Lewis McChord, WA
National Provider Identifier
1043573926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 1116
- Practice address
- 9040A Jackson Avenue
Joint Base Lewis McChord, WA 98431-0001 - Phone
- (954) 803-0395
- NPI assigned
- Jun 16, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 1116 | NE | Primary |
Addresses
Primary practice location
9040A Jackson Avenue
Joint Base Lewis McChord, WA 98431-0001
Mailing address
9040 Jackson Ave
Tacoma, WA 98431-0001
Phone (539) 968-0030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150910002182 | NE | Order and Referring Only - Internal Medicine | 1254648058 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1116 | NE | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1043573926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "539-968-0030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040A JACKSON AVENUE",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "954-803-0395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSA",
"first_name": "CESAR",
"middle_name": "JOSE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-16",
"last_updated": "2024-08-16",
"certification_date": "2024-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NE",
"license": "1116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joint Base Lewis McChord, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.