Individual provider Active NPI

Jose J Rosales, MD

  • Family Medicine Physician
  • Orange City, FL
National Provider Identifier
1295761948
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 71082 Issued in FL
Practice address
1035 Town Center Dr
Orange City, FL 32763-8360
Phone
(386) 775-8229
Fax
(386) 775-2270
NPI assigned
Jun 24, 2006
Last updated
Feb 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME 71082 FL Primary
Adolescent Medicine (Family Medicine) Physician 207QA0000X ME 71082 FL
Adult Medicine Physician 207QA0505X ME 71082 FL
Geriatric Medicine (Family Medicine) Physician 207QG0300X ME 71082 FL

Addresses

Primary practice location

1035 Town Center Dr
Orange City, FL 32763-8360

Mailing address

1035 Town Center Dr
Orange City, FL 32763-8360
Phone (386) 775-8229

Other identifiers 1

IdentifierTypeStateIssuer
31498OtherFLBLUE CROSS BLUE SHIELD FL

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

State licenses

LicenseStateTypeSpecialty
ME 71082FLMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Volusia Healthcare Corporation Past Accepting new patients
Jose J Rosales MD PA Family Medicine PastSince Jan 1, 1990 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1295761948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 TOWN CENTER DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638360",
            "telephone_number": "386-775-8229",
            "fax_number": "386-775-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 TOWN CENTER DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638360",
            "telephone_number": "386-775-8229",
            "fax_number": "386-775-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSALES",
        "first_name": "JOSE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 71082",
            "primary": true
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "FL",
            "license": "ME 71082",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME 71082",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME 71082",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "31498",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.