Individual provider Active NPI

Jennifer Magdalena Rosario, MD

  • Pediatrics Physician
  • Springfield, IL
National Provider Identifier
1083046403
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301103425 Issued in MI
Practice address
800 E Carpenter St
Springfield, IL 62769-1000
Phone
(217) 544-6464
NPI assigned
Aug 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 4301103425 MI
Pediatrics Physician 208000000X 4301103425 MI Primary

Addresses

Primary practice location

800 E Carpenter St
Springfield, IL 62769-1000

Mailing address

2489 Somerset Blvd
Apt 213
Troy, MI 48084-4003
Phone (646) 671-2779

Other names 1

  • Dr. Jennifer M Rosario Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jrosario167464@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230726001885 GA Practitioner - Pediatric Medicine 1052543980 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

Interoperability endpoints

  • Direct secure messaging: jrosario167464@ewd.direct.hshs.org

Organizations & group practices 1

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": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1083046403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2489 SOMERSET BLVD",
            "address_2": "APT 213",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844003",
            "telephone_number": "646-671-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627691000",
            "telephone_number": "217-544-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "JENNIFER",
        "middle_name": "MAGDALENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MI",
            "license": "4301103425",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301103425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrosario167464@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "800 E Carpenter St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627691000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ROSARIO",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.