NPIMap

Organization Active NPI

New Rose Healthcare Management LLC

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1043816515
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
NEW ROSE HEALTHCARE MANAGEMENT LLC
Practice address
45 W 111TH St
Chicago, IL 60628-4200
Phone
(773) 995-3000
NPI assigned
Dec 9, 2020
Last updated
Feb 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Authorized official

Name
Timothy Egan
Title
Ceo
Phone
(773) 995-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

45 W 111TH St
Chicago, IL 60628-4200

Mailing address

PO Box 7167
Carol Stream, IL 60197-7167
Phone (773) 995-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210316000179 IL Part B Supplier - Clinic/Group Practice 4981010048 Receives reassigned benefits from 50 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1043816515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7167",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601977167",
            "telephone_number": "773-995-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284200",
            "telephone_number": "773-995-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ROSE HEALTHCARE MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-995-3000"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.