Ruth Rosen, M.D.
Individual provider Active NPI Family Medicine Physician · Polacca, AZ
NPI 1124231972 · NPPES record last updated May 9, 2024
Key facts
- NPI
- 1124231972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD2006-0507 (NM)
- Practice address
- Hopi Health Care Center Higway 264
MM 388
Polacca, AZ 86042-4000 - Phone
- (928) 737-6000
- Fax
- (928) 737-6001
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000
26877 Tourney Rd
Santa Clarita, CA 91355-1846
Phone (888) 778-5000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081201000191 | CA | Practitioner - Family Practice |
7517027196 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C63110 | CA | MD | Emergency Medicine Physician |
| MD2006-0507 | NM | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Emergency Medicine | Current |
Accepting new patients |
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Emergency Medicine | Current | Accepting new patients |
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Emergency Medicine | Current |
Accepting new patients |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Chase Dennis Emergency Medical Group Inc | Emergency Medicine | Past | Accepting new patients |
| Valley Presbyterian Emergency Medical Associates | Emergency Medicine | Past |
Accepting new patients |
| Redondo Emergency Physicians, Inc. | Emergency Medicine | Past |
Accepting new patients |
| DHHS IHS Phoenix Area | Emergency Medicine | Past | Accepting new patients |
| Victor Valley Emergency Medical Associates, Inc. | Emergency Medicine | Past | Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | C63110 | CA | |
| Family Medicine Physician | 207Q00000X | MD2006-0507 | NM | Yes |
Addresses
Primary practice location
Hopi Health Care Center Higway 264
MM 388
Polacca, AZ 86042-4000
Mailing address
PO Box 4000
Polacca, AZ 86042-4000
Phone (928) 737-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 696809 | Medicaid | AZ |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Polacca, AZ
- Margaret Ann Quiller
- Gary Alan Reeves
- Emily Elizabeth Virginia Robbie
- Michael Everett Robinson
- Thomas Romard
- Nayereh Sabripour
- Elise Sage
- Carynn Sakeva
- Margie Ann Saucedo
- Lydia M Segers
All providers in Polacca, AZ · Family Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.