Jack Michael Rosenberg, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

4301051728 Issued in MI

Practice address

325 E Eisenhower Pkwy
Suite 100
Ann Arbor, MI 48108-3364

Phone

(734) 936-7175

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1104912450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E EISENHOWER PKWY",
            "address_2": "SUITE 100",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083364",
            "telephone_number": "734-936-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "JACK",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301051728",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "4301051728",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301051728",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3069240",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas S Rosenbaum, PH.D.
• Alexandra Hart Targan Rosenberg, MD
• Andrew L Rosenberg, MD
• Barry Louis Rosenberg, M.D., PHD
• Elinor B Rosenberg, MSW
• Jerry C Rosenberg, MD
• Lily Rosenberg
• Marci Erin Rosenberg
• Tania Shaina Rosenberg, RN
• Katherine Lisa Rosenblum, PH.D.

• Anesthesiology Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; 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.