Individual provider Active NPI

Elizabeth Tan Rosolowsky, M.D.

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1114138765
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
224232 Issued in MA
Practice address
333 Longwood Ave
Suite 618
Boston, MA 02115-5711
Phone
(617) 355-2185
Fax
(617) 730-0194
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 224232 MA Primary
Pediatric Endocrinology Physician 2080P0205X 224232 MA

Addresses

Primary practice location

333 Longwood Ave
Suite 618
Boston, MA 02115-5711

Mailing address

404 Mount Auburn St
Watertown, MA 02472-1968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224232MAMDPediatric Endocrinology Physician

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1114138765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 MOUNT AUBURN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024721968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LONGWOOD AVE",
            "address_2": "SUITE 618",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155711",
            "telephone_number": "617-355-2185",
            "fax_number": "617-730-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSOLOWSKY",
        "first_name": "ELIZABETH",
        "middle_name": "TAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "224232",
            "primary": true
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MA",
            "license": "224232",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.