Individual provider Active NPI

Thomas D Rosenberg, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Park City, UT
National Provider Identifier
1144273905
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
157189-1205 Issued in UT
Practice address
1820 Sidewinder Dr
Park City, UT 84060-7492
Phone
(435) 655-6600
Fax
(435) 655-2388
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 157189-1205 UT Primary

Addresses

Primary practice location

1820 Sidewinder Dr
Park City, UT 84060-7492

Mailing address

1820 Sidewinder Dr
Park City, UT 84060-7492
Phone (435) 655-6600

Other identifiers 7

IdentifierTypeStateIssuer
35743OtherUTDESERET MUTUAL INS ASSOC
841433992R02OtherUTEDUCATORS MUTUAL
0990205OtherUTUNITED HEALTH CARE
QM0000040458OtherUTALTIUS HEALTH PLANS
60843OtherUTPUBLIC EMPLOYEES HEALTH P
TPRA09041OtherUTMOLINA
107005202101OtherUTSELECT HEALTH PLANS

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
157189-1205UTMDSports Medicine (Orthopaedic Surgery) Physician

Interoperability endpoints

  • Direct secure messaging: thomas.rosenberg.1@14863.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1144273905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 SIDEWINDER DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607492",
            "telephone_number": "435-655-6600",
            "fax_number": "435-655-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 SIDEWINDER DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607492",
            "telephone_number": "435-655-6600",
            "fax_number": "435-655-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "THOMAS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "UT",
            "license": "157189-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL INS ASSOC",
            "identifier": "35743",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "841433992R02",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0990205",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS HEALTH PLANS",
            "identifier": "QM0000040458",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUBLIC EMPLOYEES HEALTH P",
            "identifier": "60843",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "TPRA09041",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH PLANS",
            "identifier": "107005202101",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.