Individual provider Active NPI

Louis Charles Rose, M.D.

  • Orthopaedic Surgery Physician
  • Bronx, NY
National Provider Identifier
1285748541
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
153790 Issued in NY
Practice address
3058 E Tremont Ave
Bronx, NY 10461-5726
Phone
(718) 409-0500
Fax
(718) 409-0306
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 153790 NY Primary
Orthopaedic Hand Surgery Physician 207XS0106X 153790 NY
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 153790 NY

Addresses

Primary practice location

3058 E Tremont Ave
Bronx, NY 10461-5726

Mailing address

530 E 76TH St Apt 27G
New York, NY 10021-3173
Phone (212) 772-8706

Other identifiers 1

IdentifierTypeStateIssuer
01088820MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050722000769 NY Practitioner - Orthopedic Surgery 0547297319 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3058 E Tremont Ave
Bronx, NY 10461-5726
Phone (718) 409-0500

Hospital & facility affiliations

  • St Joseph'S Medical Center Hospital, Yonkers, NY, CCN 330006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
153790NYMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Throgs Neck Multi Care, P.C. Orthopaedic Surgery CurrentSince Nov 15, 1989 Accepting new patients
Westchester Orthopaedic, PLLC Orthopaedic Surgery Current Accepting new patients
MK Healthcare Medical PC CurrentSince Mar 27, 2019 Accepting new patients

Locations

3058 E Tremont Ave
Bronx, NY 10461
Phone (718) 409-0500

5629 Metropolitan Ave
Ridgewood, NY 11385
Phone (718) 418-0300

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1285748541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E 76TH ST APT 27G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213173",
            "telephone_number": "212-772-8706",
            "fax_number": "718-409-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3058 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104615726",
            "telephone_number": "718-409-0500",
            "fax_number": "718-409-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "LOUIS",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "153790",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NY",
            "license": "153790",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "153790",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01088820",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.