NPIMap

Organization Active NPI

Rose Tree Medical Associates LLC

  • Internal Medicine Physician
  • Media, PA
National Provider Identifier
1093784886
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ROSE TREE MEDICAL ASSOCIATES LLC
Practice address
1098 W Baltimore Pike
Suite 3101 Outpatient Pavilion
Media, PA 19063-5139
Phone
(610) 891-9277
Fax
(610) 891-7778
NPI assigned
Mar 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Denise Gallagher, RN
Title
Office Manager
Phone
(610) 891-9277

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X PA
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X PA Primary

Addresses

Primary practice location

1098 W Baltimore Pike
Suite 3101 Outpatient Pavilion
Media, PA 19063-5139

Mailing address

1098 W Baltimore Pike
Suite 3101 Outpatient Pavilion
Media, PA 19063-5139
Phone (610) 891-9277

Other identifiers 3

IdentifierTypeStateIssuer
1012914240001MedicaidPA
1012914240002MedicaidPA
DD7693OtherPARAIL ROAD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1093784886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 W BALTIMORE PIKE",
            "address_2": "SUITE 3101 OUTPATIENT PAVILION",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139",
            "telephone_number": "610-891-9277",
            "fax_number": "610-891-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 W BALTIMORE PIKE",
            "address_2": "SUITE 3101 OUTPATIENT PAVILION",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139",
            "telephone_number": "610-891-9277",
            "fax_number": "610-891-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE TREE MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "GALLAGHER",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "610-891-9277",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012914240001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012914240002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD",
            "identifier": "DD7693",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.