Individual provider Active NPI

Diane Loria Rose, MD

  • Dermatology Physician
  • Metairie, LA
National Provider Identifier
1053302273
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD10473R Issued in LA
Practice address
2221 Clearview Pkwy
Suite 101
Metairie, LA 70001-2458
Phone
(504) 885-8363
Fax
(504) 885-1005
NPI assigned
Nov 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD10473R LA Primary

Addresses

Primary practice location

2221 Clearview Pkwy
Suite 101
Metairie, LA 70001-2458

Mailing address

2221 Clearview Pkwy
Suite 101
Metairie, LA 70001-2458
Phone (504) 885-8363

Other identifiers 1

IdentifierTypeStateIssuer
49048MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050516000009 LA Practitioner - Dermatology 0446291082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rose Dermatology and Laser Center, LLCGroup PAC ID 2365483906, 2 clinicians

Practice addresses (Care Compare)

2325 Severn Ave
Suite a
Metairie, LA 70001-6918
Phone 50488583631

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions517
Removal or shaving of skin growth1-10
Skin biopsy127

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD10473RLAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rose Dermatology & Laser Center, LLC CurrentSince Dec 1, 2004 Accepting new patients

Locations

2221 Clearview Pkwy
Ste 101
Metairie, LA 70001
Phone (504) 885-8363

2325 Severn Ave
Ste A
Metairie, LA 70001
Phone (504) 885-8363

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1053302273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 CLEARVIEW PKWY",
            "address_2": "SUITE 101",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700012458",
            "telephone_number": "504-885-8363",
            "fax_number": "504-885-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 CLEARVIEW PKWY",
            "address_2": "SUITE 101",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700012458",
            "telephone_number": "504-885-8363",
            "fax_number": "504-885-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DIANE",
        "middle_name": "LORIA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "MD10473R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49048",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.