Active NPI
Joel Bernard Rose, D.O.
- Adult Medicine Physician
- Tampa, FL
National Provider Identifier
1104928647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- OS 4694
- Practice address
- 6101 Webb Rd
Suite 207
Tampa, FL 33615-2872 - Phone
- (813) 882-3331
- Fax
- (813) 885-6209
- NPI assigned
- Sep 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | OS 4694 | FL | Primary |
Addresses
Primary practice location
6101 Webb Rd
Suite 207
Tampa, FL 33615-2872
Mailing address
PO Box 261748
Tampa, FL 33685-1748
Phone (813) 882-3331
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121119000499 | FL | Practitioner - Family Practice | 7214188374 | Practice locations: Tampa, FL |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- West Virginia School of Osteopathic Medicine, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6101 Webb Rd
Suite 207
Tampa, FL 33615-2868
Phone (813) 882-3331
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS 4694 | FL | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104928647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 261748",
"city": "TAMPA",
"state": "FL",
"postal_code": "336851748",
"telephone_number": "813-882-3331",
"fax_number": "813-885-6209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6101 WEBB RD",
"address_2": "SUITE 207",
"city": "TAMPA",
"state": "FL",
"postal_code": "336152872",
"telephone_number": "813-882-3331",
"fax_number": "813-885-6209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "JOEL",
"middle_name": "BERNARD",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "FL",
"license": "OS 4694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.