Individual provider Active NPI

Guy Raoul Rosenschein, MD

  • Pediatric Surgery Physician
  • Springdale, AR
National Provider Identifier
1114931029
Registry record updated Dec 3, 2009
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.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
E3246 Issued in AR
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

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
200387580BMedicaidKS
18920000000OtherARQUALCHOICE
5L780OtherARBLUE CROSS/BLUE SHIELD
2718271OtherARCIGNA
204878001MedicaidMO
100224750AMedicaidOK
140114001MedicaidAR
45052125072764A003OtherARCHAMPUS/TRICARE
515046OtherARHEALTHLINK

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. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2000150873MOMDPediatric 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

Verify at the official NPI Registry.