NPIMap

Individual provider Active NPI

Timothy Rose, PA-C

  • Medical Physician Assistant
  • Scranton, PA
National Provider Identifier
1174518138
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA-002994-L Issued in PA
Practice address
5 Morgan Hwy
Suite 4
Scranton, PA 18508-2641
Phone
(570) 344-3788
Fax
(570) 969-9280
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA-002994-L PA Primary

Addresses

Primary practice location

5 Morgan Hwy
Suite 4
Scranton, PA 18508-2641

Mailing address

5 Morgan Hwy
Suite 4
Scranton, PA 18508-2641
Phone (570) 344-3788

Other identifiers 4

IdentifierTypeStateIssuer
103194279-0001MedicaidPA
073695OtherPABLUE CARE
50076567OtherPACAPITAL BLUE CROSS
P00059096OtherPARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040511001287 PA Practitioner - Physician Assistant 8426047630 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pennsylvania Hospitalist Group, LLCGroup PAC ID 3870035611, 56 clinicians

Practice addresses (Care Compare)

746 Jefferson Ave
Scranton, PA 18510-1624
Phone (570) 348-7100

Hospital & facility affiliations

  • Regional Hospital of Scranton Hospital, Scranton, PA, CCN 390237
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA-002994-LPAMDMedical Physician Assistant

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1174518138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MORGAN HWY",
            "address_2": "SUITE 4",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185082641",
            "telephone_number": "570-344-3788",
            "fax_number": "570-969-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MORGAN HWY",
            "address_2": "SUITE 4",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185082641",
            "telephone_number": "570-344-3788",
            "fax_number": "570-969-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "TIMOTHY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA-002994-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103194279-0001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE",
            "identifier": "073695",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50076567",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00059096",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.