Active NPI
Jeffrey G Rosenstock, MD
- Radiation Oncology Physician
- Philadelphia, PA
National Provider Identifier
1245262567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- MD013665E
- Practice address
- 111 S 11TH St
Bodine Center
Philadelphia, PA 19107-4824 - Phone
- (215) 955-6702
- Fax
- (215) 955-5331
- NPI assigned
- Jul 7, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | MD013665E | PA | Primary |
Addresses
Primary practice location
111 S 11TH St
Bodine Center
Philadelphia, PA 19107-4824
Mailing address
111 S 11TH St
Bodine Center
Philadelphia, PA 19107-4824
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0006654740004 | Medicaid | PA | |
| 2522616 | Medicaid | NJ |
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 |
|---|---|---|---|
| MD013665E | PA | MD | Radiation Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330992000000",
"number": "1245262567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 S 11TH ST",
"address_2": "BODINE CENTER",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S 11TH ST",
"address_2": "BODINE CENTER",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074824",
"telephone_number": "215-955-6702",
"fax_number": "215-955-5331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENSTOCK",
"first_name": "JEFFREY",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2012-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "PA",
"license": "MD013665E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006654740004",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2522616",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.