Individual provider Active NPI

Brandon Rosenberg, MD

  • Emergency Medicine Physician
  • Washington, MO
National Provider Identifier
1053806844
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2021003574 Issued in MO
Practice address
901 E 5TH St
Washington, MO 63090-3127
Phone
(636) 239-8011
NPI assigned
Jun 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2021003574 MO Primary

Addresses

Primary practice location

901 E 5TH St
Washington, MO 63090-3127

Mailing address

901 E 5TH St
Washington, MO 63090-3127
Phone (636) 239-8011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20210827001232 MO Practitioner - Emergency Medicine 6406288323 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospitals East CommunitiesGroup PAC ID 3779479019, 29 clinicians

Practice addresses (Care Compare)

901 E 5TH St
Washington, MO 63090-3127
Phone (636) 239-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021003574MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Lincoln CurrentSince Mar 20, 2023 Accepting new patients
Mercy Hospital Jefferson CurrentSince Mar 20, 2023 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Mar 20, 2023 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
Mercy Hospitals East Communities CurrentSince Mar 20, 2023 Accepting new patients
Mercy Hospital South Emergency Medicine CurrentSince Mar 20, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
Mercy Hospital Jefferson CurrentSince Mar 20, 2023 Accepting new patients
Mercy Hospitals East Communities CurrentSince Mar 20, 2023 Accepting new patients
Mercy Hospital South CurrentSince Mar 20, 2023 Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Mar 20, 2023 Accepting new patients
Washington University Physicians in Illinois, Inc Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1053806844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 5TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903127",
            "telephone_number": "636-239-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E 5TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903127",
            "telephone_number": "636-239-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "BRANDON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2021003574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.