Individual provider Active NPI

Richard M Rosenthal, M.D.

  • Pain Medicine Physician
  • Provo, UT
National Provider Identifier
1073512745
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
180329-1205 Issued in UT
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

Updated by the provider on Sep 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031210000298 UT Practitioner - Pain ManagementPractitioner - AnesthesiologyPractitioner - Interventional Pain Management 3476459595

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.