Active NPI
Jeffrey Rouse
- Prosthodontics
- New York, NY
National Provider Identifier
1073711271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 050383
- Practice address
- 225 Broadway
Mezzanine Level
New York, NY 10007-3001 - Phone
- (212) 374-9500
- NPI assigned
- Jul 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 050383 | NY | Primary |
Addresses
Primary practice location
225 Broadway
Mezzanine Level
New York, NY 10007-3001
Mailing address
225 Broadway
Mezzanine Level
New York, NY 10007-3001
Phone (212) 374-9500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050383 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388016000000",
"number": "1073711271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 BROADWAY",
"address_2": "MEZZANINE LEVEL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100073001",
"telephone_number": "212-374-9500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 BROADWAY",
"address_2": "MEZZANINE LEVEL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100073001",
"telephone_number": "212-374-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUSE",
"first_name": "JEFFREY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-10",
"last_updated": "2013-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NY",
"license": "050383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.