Individual provider Active NPI

Eric Jon Roseen, D.C.

  • Chiropractor
  • Wellesley, MA
National Provider Identifier
1295013761
Registry record updated Aug 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3343 Issued in MA
Practice address
170 Worcester St
Wellesley, MA 02481-5506
Phone
(781) 431-1333
Fax
(781) 431-1933
NPI assigned
Aug 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3343 MA Primary

Addresses

Primary practice location

170 Worcester St
Wellesley, MA 02481-5506

Mailing address

170 Worcester St
Wellesley, MA 02481-5506
Phone (781) 431-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110915000076 MA Practitioner - Chiropractic 1658542055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8000

72 E Newton St
CR Evans 124
Boston, MA 02118-2308
Phone (617) 638-7253

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3343MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Medical Foundation, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients

Locations

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

Interoperability endpoints

  • Direct secure messaging: eroseen73138@direct.bmc.masshiway.net

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.

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": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1295013761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 WORCESTER ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024815506",
            "telephone_number": "781-431-1333",
            "fax_number": "781-431-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 WORCESTER ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024815506",
            "telephone_number": "781-431-1333",
            "fax_number": "781-431-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEEN",
        "first_name": "ERIC",
        "middle_name": "JON",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.