Jeffrey V Rosenberg, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DO24758 Issued in OR

Practice address

109 Hospital LN
Afton, WY 83110

Phone

(307) 886-5665

Fax

(307) 886-5665

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Emergency Medicine

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physicians Integrated Care LLCGroup PAC ID 4284548116, 203 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
• Idaho Falls Community Hospital, LLC Hospital, Idaho Falls, ID, CCN 130074

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. 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 Osteopathy

Practice roles

Locations

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.

• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199

  ID

  Medicare reassignment Care Compare group NPD
• Intermountain Emergency Physicians

  • Emergency Medicine Physician
  • Idaho Falls, ID
  • NPI 1124005467
  Medicare reassignment NPD
• Teton Valley Health Care Inc

  • Rural Health Clinic/Center
  • Driggs, ID
  • NPI 1013264183
  Medicare reassignment NPD
• Teton Valley Health Care, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Driggs, ID
  • NPI 1053669598
  NPD
• Teton Valley Health Care, Inc

  • Rural Health Clinic/Center
  • Victor, ID
  • NPI 1801143029
  NPD
• Pegasus Emergency Group Wyoming LLC

  • Emergency Medicine Physician
  • Rock Springs, WY
  • NPI 1124328927
  NPD (past)

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

• Eastern Idaho Health Services Inc

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation
• Idaho Falls Community Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1114481447
  Care Compare affiliation

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1306860531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630",
            "city": "SMOOT",
            "state": "WY",
            "postal_code": "831260630",
            "telephone_number": "307-886-5665",
            "fax_number": "307-886-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 HOSPITAL LN",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "83110",
            "telephone_number": "307-886-5665",
            "fax_number": "307-886-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "JEFFREY",
        "middle_name": "V",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO24758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "315435",
            "identifier": "BSWY",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306860531",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamara Rammell
• Red Tail Therapy LLC
• Daniel Boyd Richons, RPH
• Melissa Diane Robbins-Hutchison, LPC
• Jared Andrew Rose, DPT
• G. Nohl Sandall, PH. D.
• Stacie Santoya, PPC
• Alexander Scharmann, DPT, OCS
• Kaly Sellers, DC
• Sheridan Vamc

• Emergency Medicine Physician in Afton, WY
• Providers in Afton, WY by specialty
• Emergency Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.