Individual provider Active NPI

Eric Stephan Rosen, DPM

  • Foot & Ankle Surgery Podiatrist
  • New Milford, NJ
National Provider Identifier
1104911312
Registry record updated Jun 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
MD02379 Issued in NJ
Practice address
261 Faller Dr
Apt C
New Milford, NJ 07646-5228
Phone
(201) 288-3000
Fax
(201) 288-6434
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X MD02379 NJ Primary

Addresses

Primary practice location

261 Faller Dr
Apt C
New Milford, NJ 07646-5228

Mailing address

261 Faller Dr
Apt C
New Milford, NJ 07646-5228
Phone (201) 288-3000

Other identifiers 1

IdentifierTypeStateIssuer
7418701MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519000292 NJ Practitioner - Podiatry 5092756114 Practice locations: Teaneck, NJ

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Teaneck, NJ 07666
Phone (201) 880-5422

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue3225
Removal or shaving of skin growth410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD02379NJMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497657600000",
    "number": "1104911312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 FALLER DR",
            "address_2": "APT C",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076465228",
            "telephone_number": "201-288-3000",
            "fax_number": "201-288-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 FALLER DR",
            "address_2": "APT C",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076465228",
            "telephone_number": "201-288-3000",
            "fax_number": "201-288-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "ERIC",
        "middle_name": "STEPHAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "MD02379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7418701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, NJ

Sources for this page

Verify at the official NPI Registry.