Active NPI
Trevor Anthony Rose Jr., MD
- Diagnostic Radiology Physician
- Tampa, FL
National Provider Identifier
1124204623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- ME110862
- Practice address
- 12902 Usf Magnolia Dr
Tampa, FL 33612-9416 - Phone
- (813) 745-4673
- Fax
- (813) 449-8618
- NPI assigned
- Jan 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 001595 | GA | |
| Diagnostic Radiology Physician | 2085R0202X | ME110862 | FL | Primary |
Addresses
Primary practice location
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Mailing address
PO Box 198441
Atlanta, GA 30384-8441
Phone (813) 745-7365
Other practice location 1
1440 Clifton Rd NE Ste 111
Atlanta, GA 30322-1053
Phone (404) 712-7055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Emory University School of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 88 of 100
- Quality
- 74.04
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.96
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME110862 | FL | MD | Diagnostic Radiology Physician |
| 001595 | GA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc | Diagnostic Radiology | Current | Accepting new patients |
Locations
12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720
Interoperability endpoints
- trevor.rosejr@direct.moffitt.org
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.
-
dba Moffitt Medical Group
- Hematology & Oncology Physician
- Tampa, FL
- NPI 1306833595
Diagnostic Radiology
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Special Hospital
- Tampa, FL
- NPI 1780653618
-
dba AdventHealth Wesley Chapel
- General Acute Care Hospital
- Wesley Chapel, FL
- NPI 1073893020
-
dba AdventHealth Tampa
- General Acute Care Hospital
- Tampa, FL
- NPI 1053321919
-
dba AdventHealth Tampa Outreach Laboratory
- Clinical Medical Laboratory
- Tampa, FL
- NPI 1134766694
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1124204623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 198441",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303848441",
"telephone_number": "813-745-7365",
"fax_number": "813-449-8618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12902 USF MAGNOLIA DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336129416",
"telephone_number": "813-745-4673",
"fax_number": "813-449-8618"
}
],
"practiceLocations": [
{
"address_1": "1440 Clifton Rd NE Ste 111",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303221053",
"country_code": "US",
"telephone_number": "404-712-7055",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSE",
"first_name": "TREVOR",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-14",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "GA",
"license": "001595",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME110862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.