Individual provider Active NPI

Courtney Rosenthal, D.O.

  • Psychiatry Physician
  • Albany, OR
National Provider Identifier
1073995007
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DO201315 Issued in OR
Practice address
2730 Pacific Blvd SE
Albany, OR 97321-5075
Phone
(541) 967-3866
NPI assigned
Jun 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DO201315 OR Primary

Addresses

Primary practice location

2730 Pacific Blvd SE
Albany, OR 97321-5075

Mailing address

PO Box 100
Albany, OR 97321-0031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240404002618 OR Practitioner - Psychiatry 9436402369 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO201315ORMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Linn CurrentSince Feb 13, 2024 Accepting new patients
County of Linn CurrentSince Feb 13, 2024 Accepting new patients

Locations

2730 Pacific Blvd SE
Albany, OR 97321

445 3rd Ave SW
Albany, OR 97321
Phone (541) 924-6916

445 3rd Ave SW
#H
Albany, OR 97321

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1073995007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973210031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 PACIFIC BLVD SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973215075",
            "telephone_number": "541-967-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "COURTNEY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "DO201315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.