Individual provider Active NPI

Henrietta Rosenberg, MD

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1306835897
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
224800 Issued in NY
Practice address
1176 5TH Ave
New York, NY 10029-6503
Phone
(212) 241-6381
Fax
(212) 410-1973
NPI assigned
Oct 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 224800 NY Primary

Addresses

Primary practice location

1176 5TH Ave
New York, NY 10029-6503

Mailing address

1176 5TH Ave
New York, NY 10029-6503
Phone (212) 241-6381

Other identifiers 1

IdentifierTypeStateIssuer
02375708MedicaidNY

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
I20041216001076 NY Practitioner - Diagnostic Radiology 7113984592 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224800NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Dec 1, 2016 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Fpa Hospital Based Diagnostic Radiology CurrentSince Jun 1, 2013 Accepting new patients
Fpa Hospital Based CurrentSince Jun 1, 2013 Accepting new patients
The New York Proton Center CurrentSince Oct 1, 2020 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Diagnostic Radiology CurrentSince Dec 1, 2016 Accepting new patients
Mount Sinai School of Medicine Diagnostic Radiology Past Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients
Lincon Medical and Mental Center Diagnostic Radiology Past Accepting new patients
Downtown Bronx Medical Associates PC Past Accepting new patients

Locations

1436 Broadway
Hewlett, NY 11557
Phone (516) 563-7200

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

17E E 102nd St
#6D
New York, NY 10029
Phone (212) 241-6381

1176 5th Ave
#1235
New York, NY 10029
Phone (212) 241-6381

225 E 126th St
New York, NY 10035
Phone (646) 813-1880

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1306835897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-241-6381",
            "fax_number": "212-410-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-241-6381",
            "fax_number": "212-410-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "HENRIETTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "224800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02375708",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.