Individual provider Active NPI

Rose M Marcus, MD

  • Child & Adolescent Psychiatry Physician
  • Fresh Meadows, NY
National Provider Identifier
1245323666
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
125571 Issued in NY
Practice address
7542 Utopia Pkwy
Fresh Meadows, NY 11366-1527
Phone
(917) 359-7407
NPI assigned
Sep 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 125571 NY Primary

Addresses

Primary practice location

7542 Utopia Pkwy
Fresh Meadows, NY 11366-1527

Mailing address

7542 Utopia Pkwy
Fresh Meadows, NY 11366-1527

Other practice location 1

8268 164th St
Jamaica, NY 11432-1121
Phone (718) 883-3225

Other identifiers 1

IdentifierTypeStateIssuer
00246075MedicaidNY

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1245323666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7542 UTOPIA PKWY",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7542 UTOPIA PKWY",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661527",
            "telephone_number": "917-359-7407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8268 164th St",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114321121",
            "country_code": "US",
            "telephone_number": "718-883-3225",
            "fax_number": "718-883-6193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "ROSE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-30",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "125571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.