NPIMap

Individual provider Active NPI

Michael B Rosen, MD

  • Family Medicine Physician
  • Penn Valley, PA
National Provider Identifier
1285691659
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD042474E Issued in PA
Practice address
857 Montgomery Ave FL 1
Penn Valley, PA 19072-1541
Phone
(601) 664-2951
NPI assigned
Apr 28, 2006
Last updated
Dec 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-042474-E PA
Family Medicine Physician 207Q00000X MD042474E PA Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD042474E PA

Addresses

Primary practice location

857 Montgomery Ave FL 1
Penn Valley, PA 19072-1541

Mailing address

509 Germantown Pike
Lafayette Hill, PA 19444
Phone (610) 828-7570

Other identifiers 8

IdentifierTypeStateIssuer
1414084003OtherCIGNA
4226160OtherAETNA PPO
1015498OtherKEYSTONE MERCY
1332484OtherFIRST HEALTH NETWORK
MOP103OtherOXFORD
0016144980001MedicaidPA
0000001OtherAETNA HMO
602157OtherPAPA BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100325000745 PA Practitioner - Family Practice 6204962509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Hahnemann University College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line Medical Group LTDGroup PAC ID 9830003599, 9 clinicians

Practice addresses (Care Compare)

857 Montgomery Ave
Penn Valley, PA 19072-1541
Phone (610) 664-2951

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
21.53 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
71.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-042474-EPAMDFamily Medicine Physician
MD042474EPAMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Medical Group LTD Family Medicine CurrentSince Nov 17, 2021 Accepting new patients
Stenton Care LLC Past Accepting new patients
Yo Operating LLC Past Accepting new patients
Lafayette Hill Family Medicine PC Family Medicine PastSince Jul 31, 1998 Accepting new patients
York Operating, LLC Past Accepting new patients
Wyndmoor SNF Operating Company LLC Past Accepting new patients
Temple Physicians Inc. Family Medicine Past Accepting new patients

Locations

857 Montgomery Ave
Penn Valley, PA 19072
Phone (610) 664-2951

857 Montgomery Ave
#1
Penn Valley, PA 19072
Phone (601) 664-2951

1020 Oak Ln
Philadelphia, PA 19126
Phone (215) 224-9898

7107 Old York Rd
Philadelphia, PA 19126
Phone (267) 297-8069

7310 Stenton Ave
Philadelphia, PA 19150
Phone (215) 242-2727

8601 Stenton Ave
Wyndmoor, PA 19038
Phone (215) 233-6200

8601 Stenton Ave
Ste 100
Wyndmoor, PA 19038
Phone (267) 397-9797

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tender Care Hospice PA LLCWyndmoor, PA, CCN 731502 Hospice W-2 Managing Employee Mar 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1285691659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 GERMANTOWN PIKE",
            "city": "LAFAYETTE HILL",
            "state": "PA",
            "postal_code": "19444",
            "telephone_number": "610-828-7570",
            "fax_number": "610-941-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 MONTGOMERY AVE FL 1",
            "city": "PENN VALLEY",
            "state": "PA",
            "postal_code": "190721541",
            "telephone_number": "601-664-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD-042474-E",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD042474E",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "MD042474E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1414084003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4226160",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1015498",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NETWORK",
            "identifier": "1332484",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "MOP103",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016144980001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "0000001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "602157",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penn Valley, PA

Sources for this page

Verify at the official NPI Registry.