Individual provider Active NPI

Nicholas Elias Rose, M.D.

  • Orthopaedic Hand Surgery Physician
  • Newport Beach, CA
National Provider Identifier
1174550784
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
G74766 Issued in CA
Practice address
360 San Miguel Dr
Suite#701
Newport Beach, CA 92660-7853
Phone
(949) 759-3600
Fax
(949) 759-0282
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G74766 CA
Orthopaedic Hand Surgery Physician 207XS0106X G74766 CA Primary

Addresses

Primary practice location

360 San Miguel Dr
Suite#701
Newport Beach, CA 92660-7853

Mailing address

360 San Miguel Dr
Suite#701
Newport Beach, CA 92660-7853
Phone (949) 759-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040209000634 CA Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 7517851975 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
University of California, Geffen School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David B. HammerGroup PAC ID 3971559881, 117 clinicians

Practice addresses (Care Compare)

1051 Las Tablas Rd
Templeton, CA 93465-5603

360 San Miguel Dr
Suite 701
Newport Beach, CA 92660-5927
Phone (949) 759-3600

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)65
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74766CAMDPharmacist
G74766CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas E. Rose, MD, Inc. CurrentSince Oct 8, 2011 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients

Locations

360 San Miguel Dr
Ste 701
Newport Beach, CA 92660
Phone (949) 759-3600

Interoperability endpoints

  • Direct secure messaging: nicholas.rose.p27@direct.newportmed.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hoag Orthopedic Institute, LLCIrvine, CA, CCN 050769 Hospital Other (1.94%) Sep 1, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1174550784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 SAN MIGUEL DR",
            "address_2": "SUITE#701",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607853",
            "telephone_number": "949-759-3600",
            "fax_number": "949-759-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SAN MIGUEL DR",
            "address_2": "SUITE#701",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607853",
            "telephone_number": "949-759-3600",
            "fax_number": "949-759-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "NICHOLAS",
        "middle_name": "ELIAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G74766",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "CA",
            "license": "G74766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.