Active NPI
Gregory M. Rosner, M.D.
- Surgery Physician
- Cudahy, WI
National Provider Identifier
1245318765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 32506-20
- Practice address
- 5900 S Lake Dr.
Lakeshore Medical Clinic
Cudahy, WI 53110-3171 - Phone
- (414) 489-4190
- Fax
- (414) 489-4015
- NPI assigned
- Nov 1, 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 170092 | NY | |
| Surgery Physician | 208600000X | 32506-20 | WI | Primary |
Addresses
Primary practice location
5900 S Lake Dr.
Lakeshore Medical Clinic
Cudahy, WI 53110-3171
Mailing address
100-15TH Ave.
Ste 180
South Milwaukee, WI 53172-1160
Phone (414) 768-5430
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 88.68 of 100
- Quality
- 82.35
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.6
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 170092 | NY | MD | Surgery Physician |
| 32506-20 | WI | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Surgery | Current | Accepting new patients |
| Presbyterian Healthcare Services | Current | Accepting new patients |
Locations
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
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.
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349308800000",
"number": "1245318765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100-15TH AVE.",
"address_2": "STE 180",
"city": "SOUTH MILWAUKEE",
"state": "WI",
"postal_code": "531721160",
"telephone_number": "414-768-5430",
"fax_number": "414-762-4225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 S LAKE DR.",
"address_2": "LAKESHORE MEDICAL CLINIC",
"city": "CUDAHY",
"state": "WI",
"postal_code": "531103171",
"telephone_number": "414-489-4190",
"fax_number": "414-489-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSNER",
"first_name": "GREGORY",
"middle_name": "M.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2012-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "170092",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "32506-20",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cudahy, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.