Mark Rose, M.D.

Individual provider Active NPI Emergency Medicine Physician · McMinnville, OR

NPI 1124059548 · NPPES record last updated Dec 19, 2007

Key facts

NPI
1124059548
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Medicine Physician 207P00000X
License
MD14469 (OR)
Practice address
2700 SE Stratus Ave
McMinnville, OR 97128-6255
Phone
(503) 472-6131
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health West Valley Past Accepting new patients
Albany Emergency Physicians Services, PC Emergency Medicine Past Accepting new patients
Emergency Medical Associates of McMinnville Emergency Medicine Past Accepting new patients
Firstcare Medical Foundation Emergency Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD14469 OR Yes

Addresses

Primary practice location

2700 SE Stratus Ave
McMinnville, OR 97128-6255

Mailing address

PO Box 2065
Seattle, WA 98111-2065
Phone (888) 828-3195

Other identifiers

IdentifierTypeStateIssuer
D86800OtherGROUP HEALTH
068783MedicaidOR
055542001OtherBCBS
57597OtherWA L&I
XPY186301MedicaidCA
D86800OtherPROVIDENCE
8202269MedicaidWA
930027259OtherRAILROAD MEDICARE
JM9461OtherPACC

Other providers in McMinnville, OR

All providers in McMinnville, OR · Emergency Medicine Physician in Oregon

Sources for this page

Verify at the official NPI Registry.