Organization Active NPI

Matt T Rosenberg PC

Doing business as Mid-Michigan Health Centers

  • Family Medicine Physician
  • Jackson, MI
National Provider Identifier
1063692556
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301065227 Issued in MI
Legal business name
MATT T ROSENBERG PC
Doing business as
Mid-Michigan Health Centers
Practice address
214 N West Ave
Jackson, MI 49201-1903
Phone
(517) 784-9189
Fax
(517) 784-9657
NPI assigned
Nov 13, 2007
Last updated
Sep 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Authorized official

Name
Kari McCann
Title
Office Manager
Phone
(517) 784-9189

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301065227 MI Primary

Addresses

Primary practice location

214 N West Ave
Jackson, MI 49201-1903

Mailing address

214 N West Ave
Jackson, MI 49201-1903
Phone (517) 784-9189

Other practice location 1

4304 Page Ave
Michigan Center, MI 49254-1078
Phone (517) 784-9189

Other identifiers 1

IdentifierTypeStateIssuer
3388780MedicaidMI

Other names 1

  • Mid-Michigan Health Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040802000589 MI Part B Supplier - Clinic/Group Practice 6507837986 Receives reassigned benefits from 4 practitioners
Practice locations: Jackson, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0378357Matt T Rosenberg, PC214 N West Ave, Jackson, MI 49201Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1063692556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011903",
            "telephone_number": "517-784-9189",
            "fax_number": "517-784-9657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011903",
            "telephone_number": "517-784-9189",
            "fax_number": "517-784-9657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4304 Page Ave",
            "address_purpose": "LOCATION",
            "city": "Michigan Center",
            "state": "MI",
            "postal_code": "492541078",
            "country_code": "US",
            "telephone_number": "517-784-9189",
            "fax_number": "517-784-9657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MATT T ROSENBERG PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "KARI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "517-784-9189"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301065227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3388780",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-Michigan Health Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.