Individual provider Active NPI

Marc J Rosenberg, DC

  • Chiropractor
  • Euclid, OH
National Provider Identifier
1073629382
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2509 Issued in OH
Practice address
22308 Lakeshore Blvd
Euclid, OH 44123
Phone
(216) 289-2500
Fax
(216) 289-2585
NPI assigned
Aug 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2509 OH Primary

Addresses

Primary practice location

22308 Lakeshore Blvd
Euclid, OH 44123

Mailing address

22308 Lakeshore Blvd
Euclid, OH 44123
Phone (216) 289-2500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090506000194 OH Practitioner - Chiropractic 9133277858 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2509OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Pain Management & Chiropractic LLC Chiropractor CurrentSince Feb 1, 2009 Accepting new patients
Warrensville Physical Medicine & Chiropractic Rehabilitation, LLC Chiropractor CurrentSince Feb 1, 2009 Accepting new patients
Physical Medicine and Chiropractic Rehabilitation LLC Chiropractor CurrentSince Oct 25, 2000 Accepting new patients

Locations

22308 Lake Shore Blvd
Euclid, OH 44123
Phone (216) 289-2500

1451 W 117th St
Lakewood, OH 44107
Phone (216) 529-0181

4919 Warrensville Center Rd
Warrensville Heights, OH 44128
Phone (216) 475-9977

4919 Warrensville Ctr
#R
Warrensville Heights, OH 44128
Phone (216) 475-9977

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073629382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22308 LAKESHORE BLVD",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "44123",
            "telephone_number": "216-289-2500",
            "fax_number": "216-289-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22308 LAKESHORE BLVD",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "44123",
            "telephone_number": "216-289-2500",
            "fax_number": "216-289-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "MARC",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.