Active NPI
Matthew William Rosenberg, M.D.
- Plastic and Reconstructive Surgery Physician
- Gallipolis, OH
National Provider Identifier
1235293275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 35.083418
- Practice address
- 90 Jackson Pike
Gallipolis, OH 45631-1560 - Phone
- (740) 446-5225
- Fax
- (740) 441-8097
- NPI assigned
- Dec 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 23441 | WV | |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 35.083418 | OH | Primary |
Addresses
Primary practice location
90 Jackson Pike
Gallipolis, OH 45631-1560
Mailing address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5225
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2444000 | Medicaid | OH | |
| 000000241633 | Other | OH | OH MEDICAID MOLINA |
| 3810002080 | Medicaid | WV | |
| 000000241633 | Other | OH | OH MEDICAID UNISON |
| 310917085189 | Other | OH | OH MEDICAID CARESOURCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23441 | WV | MD | Plastic and Reconstructive Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osu Surgery, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Surgery Physician
- Columbus, OH
- NPI 1538117551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423440000000",
"number": "1235293275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "740-446-5225",
"fax_number": "740-441-8097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "740-446-5225",
"fax_number": "740-441-8097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBERG",
"first_name": "MATTHEW",
"middle_name": "WILLIAM",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-21",
"last_updated": "2015-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "WV",
"license": "23441",
"primary": false
},
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "OH",
"license": "35.083418",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2444000",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH MEDICAID MOLINA",
"identifier": "000000241633",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810002080",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH MEDICAID UNISON",
"identifier": "000000241633",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH MEDICAID CARESOURCE",
"identifier": "310917085189",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gallipolis, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.