Kenneth B Rosen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

270A00349600 Issued in NJ

Practice address

26-07 Broadway
Fair Lawn, NJ 07410-3832

Phone

(201) 796-3050

Fax

(201) 796-3385

NPI assigned

Jan 30, 2006

Last updated

Apr 4, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1144291931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26-07 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103832",
            "telephone_number": "201-796-3050",
            "fax_number": "201-796-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26-07 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103832",
            "telephone_number": "201-796-3050",
            "fax_number": "201-796-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "KENNETH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00349600",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NJ",
            "license": "27T000072100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha C Romano, OTR/L
• Rooted Living LLC
• Evangelina M. Roque, NP-C
• Jose Luis Rosado
• Brad Rosen
• Lon J Rosen, DDS
• Stacey L Rosen, RPT
• Erica L. Rosenberg, MS, OTR/L
• Jerald N. Rosenberg, D.M.D.
• Julia Maria Rosenberg, LAC

• Optometrist in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; 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.

Verify at the official NPI Registry.