Susan A Rose, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

14809 Issued in OK

Practice address

1725 E 19TH St
Suite 800
Tulsa, OK 74104-5472

Phone

(918) 301-2505

Fax

(918) 301-3633

NPI assigned

Jul 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1073544250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST",
            "address_2": "SUITE 800",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045472",
            "telephone_number": "918-301-2505",
            "fax_number": "918-301-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E 19TH ST",
            "address_2": "SUITE 800",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045472",
            "telephone_number": "918-301-2505",
            "fax_number": "918-301-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "SUSAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "14809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100162600A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020047731",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyleigh Janai Rose
• Natalie Deeann Rose, PA-C
• Robert Eugene Rose, CRNA
• Stephanie Faith Rose, PTA
• Steve E Rose, DO
• Sierra Rosebrough
• Rebecca Ann Roselle
• Allan Gregory Rosenfeld, MD
• Jaeden Nicole Rosenquist
• Autumn Rosenthal, PT, DPT

• Surgery Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.