Individual provider Active NPI

Larry A. Rosen, M.D.

  • Hematology & Oncology Physician
  • Independence, MO
National Provider Identifier
1124099684
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
R7864 Issued in MO
Practice address
19550 E 39TH St S
Ste 400
Independence, MO 64057-2303
Phone
(816) 698-8290
Fax
(816) 698-8291
NPI assigned
Jan 31, 2006
Last updated
Apr 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X R7864 MO Primary
Hematology & Oncology Physician 207RH0003X 04-29598 KS

Addresses

Primary practice location

19550 E 39TH St S
Ste 400
Independence, MO 64057-2303

Mailing address

19550 E 39TH St S
Ste 400
Independence, MO 64057-2303
Phone (816) 698-8290

Other identifiers 2

IdentifierTypeStateIssuer
100387530AMedicaidKS
201221611MedicaidMO

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
04-29598KSMDHematology & Oncology Physician
R7864MOMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas City Cancer Center, LLC Hematology & Oncology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: larry.rosen@hca2.eclinicaldirectplus.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1124099684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S",
            "address_2": "STE 400",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572303",
            "telephone_number": "816-698-8290",
            "fax_number": "816-698-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S",
            "address_2": "STE 400",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572303",
            "telephone_number": "816-698-8290",
            "fax_number": "816-698-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "LARRY",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MO",
            "license": "R7864",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "KS",
            "license": "04-29598",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100387530A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201221611",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; 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.