Richard M Rose, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20244 Issued in MN

Practice address

2500 Como Ave
Mail Stop 31100a
St Paul, MN 55108-1460

Phone

(651) 641-6200

Fax

(651) 641-6205

NPI assigned

Feb 1, 2006

Reactivated

Feb 13, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1336110873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 COMO AVE",
            "address_2": "MAIL STOP 31100A",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551081460",
            "telephone_number": "651-641-6200",
            "fax_number": "651-641-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "RICHARD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2024-02-13",
        "certification_date": "2020-01-13",
        "deactivation_date": "2024-01-24",
        "reactivation_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "20244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "841282100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Roschen, PNP-PC
• Rose Chiropractic Care, P. a.
• Catherine Horwath Rose, RN ANP MA
• Emily Rose, MD
• Kimberly Rose, MS
• Sarah Nicole Rose
• David John Roseborough, PH.D., LICSW
• Frayda Ilene Rosen, PSYD
• Mary Leah Genevieve Rosen
• Leigh Amy Rosenberg, MSW, LGSW

• Internal Medicine Physician in St Paul, MN
• Providers in St Paul, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.