Individual provider Active NPI

Alexander Luis Rosado

  • Physician Assistant
  • Waterbury, CT
National Provider Identifier
1053154500
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6789 Issued in CT
Practice address
500 Chase Pkwy
Waterbury, CT 06708-3346
Phone
(203) 755-6677
NPI assigned
Jun 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6789 CT Primary

Addresses

Primary practice location

500 Chase Pkwy
Waterbury, CT 06708-3346

Mailing address

500 Chase Pkwy
Waterbury, CT 06708-3346
Phone (203) 755-6677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241011000991 CT Practitioner - Physician Assistant 6901338227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurosurgery Orthopaedics and Spine Specialists PCGroup PAC ID 8820087463, 16 clinicians

Practice addresses (Care Compare)

500 Chase Pkwy
Waterbury, CT 06708-3346
Phone (203) 755-6677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6789CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgery, Orthopaedics & Spine Specialists, PC CurrentSince Oct 14, 2024 Accepting new patients

Locations

500 Chase Pkwy
Waterbury, CT 06708
Phone (203) 264-7999

500 Chase Pkwy
Fl 1
Waterbury, CT 06708
Phone (203) 754-2266

Organizations & group practices 2

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": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1053154500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CHASE PKWY",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083346",
            "telephone_number": "203-755-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CHASE PKWY",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083346",
            "telephone_number": "203-755-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO",
        "first_name": "ALEXANDER",
        "middle_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "6789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.