Individual provider Active NPI

Cristobal Rosario, M.D.

  • Internal Medicine Physician
  • Palm Harbor, FL
National Provider Identifier
1104808153
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME68810 Issued in FL
Practice address
3890 Tampa Rd
Suite 307
Palm Harbor, FL 34684-3676
Phone
(727) 786-6155
Fax
(727) 781-9899
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME68810 FL Primary

Addresses

Primary practice location

3890 Tampa Rd
Suite 307
Palm Harbor, FL 34684-3676

Mailing address

3890 Tampa Rd
Suite 307
Palm Harbor, FL 34684-3676
Phone (727) 786-6155

Other identifiers 2

IdentifierTypeStateIssuer
378616100MedicaidFL
264028700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060417000455 FL Practitioner - Internal Medicine 0749299923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

4740 Rowan Rd
New Port Richey, FL 34653-5601
Phone (727) 392-8682

5347 Main St
Suite 202
New Port Richey, FL 34652-2520
Phone (727) 841-0515

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME68810FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cristobal R. Rosario M.D., P.a. Internal Medicine CurrentSince Jul 19, 1995 Accepting new patients

Locations

4740 Rowan Rd
New Port Richey, FL 34653
Phone (727) 392-8682

3890 Tampa Rd
Ste 307
Palm Harbor, FL 34684
Phone (727) 786-6155

3830 Tampa Rd
Ste 500
Palm Harbor, FL 34684
Phone (727) 786-6155

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBDEBA/Endpoint/IBDEBA
  • Direct secure messaging: cristobal.rosario@crrmp.eclinicaldirectplus.com

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1104808153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 TAMPA RD",
            "address_2": "SUITE 307",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843676",
            "telephone_number": "727-786-6155",
            "fax_number": "727-781-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 TAMPA RD",
            "address_2": "SUITE 307",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843676",
            "telephone_number": "727-786-6155",
            "fax_number": "727-781-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "CRISTOBAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME68810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378616100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264028700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.