Individual provider Active NPI

Regina M Rosace, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Cleveland, OH
National Provider Identifier
1053406678
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
35-064926 Issued in OH
Practice address
11100 Euclid Avenue
Cleveland, OH 44106
Phone
(216) 844-7700
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 35-064926 OH Primary

Addresses

Primary practice location

11100 Euclid Avenue
Cleveland, OH 44106

Mailing address

24701 Euclid Ave
3Rd Floor
Euclid, OH 44117-1714

Other identifiers 9

IdentifierTypeStateIssuer
2018515MedicaidOH
745965OtherOHBUCKEYE
000000526093OtherOHANTHEM
2018515OtherOHBCMH
000000027623OtherOHANTHEM
1020967470001OtherPAPA MEDICAID
363965OtherOHWELLCARE
000000221289OtherOHUNISON
801820OtherOHAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20050711000842 OH Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 9234165200 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-064926OHMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince May 20, 2012 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

24701 Euclid Ave
Fl 3
Euclid, OH 44117
Phone (216) 383-6950

20800 Harvard Rd
Fl 2
Highland Hills, OH 44122
Phone (216) 358-2156

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1053406678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "3RD FLOOR",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVENUE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44106",
            "telephone_number": "216-844-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSACE",
        "first_name": "REGINA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "OH",
            "license": "35-064926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018515",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "745965",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000526093",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "2018515",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000027623",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA MEDICAID",
            "identifier": "1020967470001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "363965",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000221289",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "801820",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.