Individual provider Active NPI

Samuel K Rosemberg, M.D.

  • Legal Medicine
  • Novi, MI
National Provider Identifier
1053300830
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
SR036293 Issued in MI
Practice address
41935 W 12 Mile Rd
Suite 308
Novi, MI 48377-3111
Phone
(248) 735-2441
NPI assigned
Oct 14, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X SR036293 MI Primary

Addresses

Primary practice location

41935 W 12 Mile Rd
Suite 308
Novi, MI 48377-3111

Mailing address

41935 W 12 Mile Rd
Suite 308
Novi, MI 48377-3111
Phone (248) 735-2441

Other identifiers 1

IdentifierTypeStateIssuer
1284777MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
SR036293MIMDLegal Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sam Rosemberg MD PC PastSince Oct 17, 2005 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053300830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41935 W 12 MILE RD",
            "address_2": "SUITE 308",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773111",
            "telephone_number": "248-735-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41935 W 12 MILE RD",
            "address_2": "SUITE 308",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773111",
            "telephone_number": "248-735-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEMBERG",
        "first_name": "SAMUEL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "MI",
            "license": "SR036293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1284777",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.