Active NPI
Richard M Rosenthal, M.D.
- Pain Medicine Physician
- Provo, UT
National Provider Identifier
1073512745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- 180329-1205
- Practice address
- 3585 N University Ave Ste 150
Provo, UT 84604-6630 - Phone
- (801) 356-6100
- Fax
- (801) 356-2113
- NPI assigned
- Jul 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine Physician | 208VP0000X | 180329-1205 | UT | Primary |
Addresses
Primary practice location
3585 N University Ave Ste 150
Provo, UT 84604-6630
Mailing address
3585 N University Ave Ste 150
Provo, UT 84604-6630
Phone (801) 356-6100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031210000298 | UT | Practitioner - Pain Management | 3476459595 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- richard.rosenthal@319.chartlogic.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315267200000",
"number": "1073512745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3585 N UNIVERSITY AVE STE 150",
"city": "PROVO",
"state": "UT",
"postal_code": "846046630",
"telephone_number": "801-356-6100",
"fax_number": "801-356-2113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3585 N UNIVERSITY AVE STE 150",
"city": "PROVO",
"state": "UT",
"postal_code": "846046630",
"telephone_number": "801-356-6100",
"fax_number": "801-356-2113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENTHAL",
"first_name": "RICHARD",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-15",
"last_updated": "2011-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "UT",
"license": "180329-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.