Individual provider Active NPI

Seth Avery Rosenberg, M.D.

  • Emergency Medicine Physician
  • Saint Marys, OH
National Provider Identifier
1144313164
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35055474 Issued in OH
Practice address
200 Saint Clair Ave
Saint Marys, OH 45885-2400
Phone
(419) 394-3387
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35055474 OH Primary

Addresses

Primary practice location

200 Saint Clair Ave
Saint Marys, OH 45885-2400

Mailing address

332 Congress Park Dr
Dayton, OH 45459-4133
Phone (937) 312-3627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040126000407 OH Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8022910439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35055474OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JTDM Family Practice LLC Past Accepting new patients
Bucyrus Emergency Physicians Inc Emergency Medicine Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1144313164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 CONGRESS PARK DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594133",
            "telephone_number": "937-312-3627",
            "fax_number": "937-312-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852400",
            "telephone_number": "419-394-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "SETH",
        "middle_name": "AVERY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35055474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, OH

Sources for this page

Verify at the official NPI Registry.