Individual provider Active NPI

Leslie Dana-Rose Rosenberg, PA-C

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1235428905
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA058180 Issued in PA
Practice address
1718 Welsh Rd
Suite a
Philadelphia, PA 19115-4213
Phone
(215) 673-1700
NPI assigned
Apr 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA058180 PA
Medical Physician Assistant 363AM0700X MA058180 PA Primary

Addresses

Primary practice location

1718 Welsh Rd
Suite a
Philadelphia, PA 19115-4213

Mailing address

1718 Welsh Rd
Suite a
Philadelphia, PA 19115-4213
Phone (215) 673-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20190117003713 PA Practitioner - Physician Assistant 4789806175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinnacle Physicians Group LLCGroup PAC ID 2769631621, 31 clinicians

Practice addresses (Care Compare)

339 E St Rd
Stoltz and Hahn Medical Associates
Trevose, PA 19053
Phone (215) 464-4111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA058180PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Burstein Medical Associates, P.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: leslie.rosenberg@uram.eclinicaldirectplus.com

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": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1235428905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 WELSH RD",
            "address_2": "SUITE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154213",
            "telephone_number": "215-673-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 WELSH RD",
            "address_2": "SUITE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154213",
            "telephone_number": "215-673-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "LESLIE",
        "middle_name": "DANA-ROSE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058180",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.