Individual provider Active NPI

Mark S. Rosenberg, DO

  • Emergency Medicine Physician
  • Denville, NJ
National Provider Identifier
1184622045
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB06960500 Issued in NJ
Practice address
38 N Ridge Rd
Denville, NJ 07834-9629
Phone
(973) 224-0570
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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 25MB06960500 NJ Primary

Addresses

Primary practice location

38 N Ridge Rd
Denville, NJ 07834-9629

Mailing address

38 N Ridge Rd
Denville, NJ 07834-9629
Phone (973) 224-0570

Other identifiers 1

IdentifierTypeStateIssuer
8085005MedicaidNJ

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040916000182 NJ Practitioner - Emergency Medicine 8628061728 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB06960500NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Emergency Physicians Inc CurrentSince Oct 25, 2010 Accepting new patients
Hoboken Emergency Physicians, PC Emergency Medicine Past Accepting new patients
Evergreen Physicians of North Jersey, PC PastSince Dec 8, 2006 Accepting new patients
Essex Emergency Physicians, PC Emergency Medicine Past Accepting new patients

Locations

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

Organizations & group practices 4

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1184622045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 N RIDGE RD",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078349629",
            "telephone_number": "973-224-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 N RIDGE RD",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078349629",
            "telephone_number": "973-224-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "MARK",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB06960500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8085005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denville, NJ

Sources for this page

Verify at the official NPI Registry.