Active NPI
Guy Raoul Rosenschein, MD
- Pediatric Surgery Physician
- Springdale, AR
National Provider Identifier
1114931029
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jun 20, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- E3246
- Practice address
- 5230 Willow Creek Dr
Suite 201
Springdale, AR 72762-0876 - Phone
- (479) 927-3100
- Fax
- (479) 927-3131
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | E3246 | AR | Primary |
| Pediatric Surgery Physician | 2086S0120X | 2000150873 | MO |
Addresses
Primary practice location
5230 Willow Creek Dr
Suite 201
Springdale, AR 72762-0876
Mailing address
PO Box 6220
Springdale, AR 72766-6220
Phone (479) 927-3100
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200387580B | Medicaid | KS | |
| 18920000000 | Other | AR | QUALCHOICE |
| 5L780 | Other | AR | BLUE CROSS/BLUE SHIELD |
| 2718271 | Other | AR | CIGNA |
| 204878001 | Medicaid | MO | |
| 100224750A | Medicaid | OK | |
| 140114001 | Medicaid | AR | |
| 45052125072764A003 | Other | AR | CHAMPUS/TRICARE |
| 515046 | Other | AR | HEALTHLINK |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000150873 | MO | MD | Pediatric Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259798400000",
"number": "1114931029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6220",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727666220",
"telephone_number": "479-927-3100",
"fax_number": "479-927-3131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5230 WILLOW CREEK DR",
"address_2": "SUITE 201",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727620876",
"telephone_number": "479-927-3100",
"fax_number": "479-927-3131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENSCHEIN",
"first_name": "GUY",
"middle_name": "RAOUL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2009-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "AR",
"license": "E3246",
"primary": true
},
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "MO",
"license": "2000150873",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200387580B",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCHOICE",
"identifier": "18920000000",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "5L780",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2718271",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204878001",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100224750A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140114001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS/TRICARE",
"identifier": "45052125072764A003",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "515046",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.