Individual provider Active NPI

Mark Rosen, P.A.

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1215393210
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109199 Issued in FL
Practice address
8128 Granada Blvd
Orlando, FL 32836-5332
Phone
(561) 715-5357
NPI assigned
Jan 6, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109199 FL Primary

Addresses

Primary practice location

8128 Granada Blvd
Orlando, FL 32836-5332

Mailing address

8895 N Military TRL Ste 201C
West Palm Beach, FL 33410-6212
Phone (561) 715-5357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160401001541 FL Practitioner - Physician Assistant 7911204169 Reassigns benefits to 3 organizations
I20210520002518 CO Practitioner - Physician Assistant 7911204169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.04 of 100Reported as group
Quality
87.35
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Emergency Physician Services Inc Physician Assistant CurrentSince Jan 2, 2025 Accepting new patients
Emergency Physicians of the Rockies, PC CurrentSince May 1, 2021 Accepting new patients
Sheridan Emergency Physician Services Inc Physician Assistant CurrentSince Jan 2, 2025 Accepting new patients

Locations

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073

160 NW 170th St
North Miami Beach, FL 33169
Phone (305) 585-8957

4600 SW 46th Ct
Ocala, FL 34474
Phone (352) 291-3000

Organizations & group practices 5

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": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1215393210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8895 N MILITARY TRL STE 201C",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334106212",
            "telephone_number": "561-715-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8128 GRANADA BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365332",
            "telephone_number": "561-715-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "MARK",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-06",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.