Individual provider Active NPI

Robert Glenn Rosen, DPM

  • Podiatrist
  • Titusville, FL
National Provider Identifier
1336110832
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO2465 Issued in FL
Practice address
850 Garden St
Titusville, FL 32796-3411
Phone
(321) 267-3233
Fax
(321) 267-5141
NPI assigned
Feb 1, 2006
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO2465 FL Primary
Foot & Ankle Surgery Podiatrist 213ES0103X PO2465 FL

Addresses

Primary practice location

850 Garden St
Titusville, FL 32796-3411

Mailing address

850 Garden St
Titusville, FL 32796-3411
Phone (321) 267-3233

Other identifiers 2

IdentifierTypeStateIssuer
P00179443OtherFLMEDICARE RAILROAD
65433OtherFLBLUE CROSS BLUE SHEILD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041109000502 FL Practitioner - Podiatry 5890758098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

850 Garden St
Titusville, FL 32796-3411
Phone (321) 267-3233

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue359
Removal of nail tissue529
Removal or shaving of skin growth286
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO2465FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
RGR Ventures LLC Podiatrist CurrentSince Sep 15, 2004 Accepting new patients

Locations

850 Garden St
Titusville, FL 32796
Phone (321) 267-3233

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1336110832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963411",
            "telephone_number": "321-267-3233",
            "fax_number": "321-267-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963411",
            "telephone_number": "321-267-3233",
            "fax_number": "321-267-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "ROBERT",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2465",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO2465",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00179443",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "65433",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.