Individual provider Active NPI

Peter Rosa, DC

  • Chiropractor
  • Baltimore, MD
National Provider Identifier
1205590262
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S04112 Issued in MD
Practice address
1001 Pine Heights Ave Ste 304
Baltimore, MD 21229-5285
Phone
(410) 878-2530
Fax
(667) 223-1982
NPI assigned
Oct 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S04112 MD Primary

Addresses

Primary practice location

1001 Pine Heights Ave Ste 304
Baltimore, MD 21229-5285

Mailing address

30 W Gude Dr Ste 375
Rockville, MD 20850-4300
Phone (301) 545-0800

Other practice location 1

30 W Gude Dr Ste 375
Rockville, MD 20850-4300
Phone (301) 545-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211208001006 MD Practitioner - Chiropractic 0345630208 Reassigns benefits to 1 organization
I20211223000230 DC Practitioner - Chiropractic 0345630208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Research CT
Suite 160
Rockville, MD 20850-3299
Phone (301) 545-0800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Heights Integrative Health, LLC CurrentSince Nov 1, 2021 Accepting new patients
Rosa Chiropractic and Physical Therapy Center LLC Chiropractor CurrentSince Oct 22, 2021 Accepting new patients

Locations

1001 Pine Heights Ave
Ste 304
Baltimore, MD 21229
Phone (410) 646-0220

30 W Gude Dr
Ste 375
Rockville, MD 20850
Phone (301) 545-0800

1 Research Ct
Ste 160
Rockville, MD 20850
Phone (301) 363-7657

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.

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1205590262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W GUDE DR STE 375",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504300",
            "telephone_number": "301-545-0800",
            "fax_number": "301-545-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 PINE HEIGHTS AVE STE 304",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295285",
            "telephone_number": "410-878-2530",
            "fax_number": "667-223-1982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 W Gude Dr Ste 375",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208504300",
            "country_code": "US",
            "telephone_number": "301-545-0800",
            "fax_number": "301-545-0885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSA",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S04112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.