Phillip D Rose, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00182600 Issued in NJ

Practice address

222 Cedar Lane
Suite 120
Teaneck, NJ 07666

Phone

(201) 836-5332

Fax

(201) 836-4002

NPI assigned

Sep 13, 2007

Last updated

Mar 2, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern Orthopedic Associates MD PAGroup PAC ID 7810966611, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Eastern Orthopedic Associates, MD PA

  • Orthopaedic Surgery Physician
  • Teaneck, NJ
  • NPI 1144406521
  Medicare reassignment Care Compare group
• Anna J. Lavotshkin, MD, PC

  • Internal Medicine Physician
  • Teaneck, NJ
  • NPI 1235429911
  Medicare reassignment
• Heritage Surgical Group, LLC

  • Surgery Physician
  • Teaneck, NJ
  • NPI 1346674090
  Medicare reassignment
• Intra-Op First Assist Services

  • Surgical Physician Assistant
  • Teaneck, NJ
  • NPI 1538555784
  Authorized official Same address or phone

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

• Holy Name Hospital Regional Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Teaneck, NJ
  • NPI 1043389349

  Hospital

  Care Compare affiliation
• Holy Name Medical Center Inc.

  • General Acute Care Hospital
  • Teaneck, NJ
  • NPI 1104859131
  Care Compare affiliation

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1205021060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492C CEDAR LN",
            "address_2": "SUITE 120",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661713",
            "telephone_number": "201-357-5468",
            "fax_number": "201-636-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 CEDAR LANE",
            "address_2": "SUITE 120",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "07666",
            "telephone_number": "201-836-5332",
            "fax_number": "201-836-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "PHILLIP",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-13",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00182600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roque Medical LLC (Roque Medical)
• Ashley Mireya Rosado
• Rosanna Hodesto MD PA
• Rosanna Modesto MD PA
• Eric Rose, PH.D.
• Amy Rosen, MD
• Howard David Rosen, DMD
• Ivy Rosen, MD
• Joseph Aryeh Rosenbaum, MD
• Mireille Rosenbaum, MSW

• Physician Assistant in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.