Individual provider Active NPI

Stanley Allen Rosenberg, M.D.

  • Internal Medicine Physician
  • South Pasadena, FL
National Provider Identifier
1144337262
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME22511 Issued in FL
Practice address
2525 Pasadena Avenue South
Suite U
South Pasadena, FL 33707-4559
Phone
(727) 381-4430
Fax
(727) 381-9630
NPI assigned
Aug 24, 2006
Last updated
May 22, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME22511 FL Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME22511 FL

Addresses

Primary practice location

2525 Pasadena Avenue South
Suite U
South Pasadena, FL 33707-4559

Mailing address

PO Box 1830
Clearwater, FL 33757-1830
Phone (727) 532-0002

Other identifiers 2

IdentifierTypeStateIssuer
057160100MedicaidFL
P01022905OtherFLMEDICARE RAILROAD PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120125000560 FL Practitioner - Internal Medicine 8527235969 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Sep 1, 2015 Accepting new patients
St Anthony's Primary Care LLC Internal Medicine Past Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2525 Pasadena Ave S
Ste U
South Pasadena, FL 33707
Phone (727) 381-4430

1201 5th Ave N
Ste 408
St Petersburg, FL 33705
Phone (727) 894-3733

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1144337262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1830",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337571830",
            "telephone_number": "727-532-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 PASADENA AVENUE SOUTH",
            "address_2": "SUITE U",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337074559",
            "telephone_number": "727-381-4430",
            "fax_number": "727-381-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "STANLEY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME22511",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME22511",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057160100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PROVIDER NUMBER",
            "identifier": "P01022905",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, FL

Sources for this page

Verify at the official NPI Registry.