Organization Active NPI

Martin L. Rossman, M.D., a Professional Corporation

  • General Practice Physician
  • Greenbrae, CA
National Provider Identifier
1124310636
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
C032668 Issued in CA
Legal business name
MARTIN L. ROSSMAN, M.D., A PROFESSIONAL CORPORATION
Practice address
1341 S Eliseo Dr
Suite 350
Greenbrae, CA 94904-2000
Phone
(415) 925-8600
Fax
(415) 925-8604
NPI assigned
May 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Authorized official

Name
Dr. Martin L. Rossman, M.D.NPI 1235238791
Title
Owner
Phone
(415) 925-8600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X C032668 CA Primary

Addresses

Primary practice location

1341 S Eliseo Dr
Suite 350
Greenbrae, CA 94904-2000

Mailing address

1341 S Eliseo Dr
Suite 350
Greenbrae, CA 94904-2000
Phone (415) 925-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110916000064 CA Part B Supplier - Clinic/Group Practice 3476724733 Receives reassigned benefits from 1 practitioner
Practice locations: Greenbrae, CA

National Provider Directory

National Provider Directory

Locations

1341 S Eliseo Dr
Ste 350
Greenbrae, CA 94904
Phone (415) 925-8600

10 Willow St
Mill Valley, CA 94941
Phone (415) 383-3197

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1124310636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 S ELISEO DR",
            "address_2": "SUITE 350",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042000",
            "telephone_number": "415-925-8600",
            "fax_number": "415-925-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 S ELISEO DR",
            "address_2": "SUITE 350",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042000",
            "telephone_number": "415-925-8600",
            "fax_number": "415-925-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN L. ROSSMAN, M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "ROSSMAN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-925-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "C032668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.