Individual provider Active NPI

Roger Craig Rosen, M.D.

  • Vascular Surgery Physician
  • Hyannis, MA
National Provider Identifier
1336179191
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
53027 Issued in MA
Practice address
100 Camp St
Hyannis, MA 02601-3063
Phone
(508) 775-1984
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 53027 MA Primary

Addresses

Primary practice location

100 Camp St
Hyannis, MA 02601-3063

Mailing address

100 Camp St
Hyannis, MA 02601-3063
Phone (508) 775-1984

Other identifiers 6

IdentifierTypeStateIssuer
230000567OtherMARR MEDICARE
29059OtherMAHARVARD PILGRIM HEALTHCAR
722914OtherMATUFTS MEDICARE PREFERRED
17-01032OtherMAUNITED HEALTHCARE
6177735MedicaidMA
J03236OtherMABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040625000512 MA Practitioner - Vascular SurgeryPractitioner - General Surgery 1355325598 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Bedford Vascular Surgical Associates PastSince Apr 1, 1992 Accepting new patients
Cape Cod Hospital Inc Past Accepting new patients
Stephen J. Hoenig, MD, PC Vascular Surgery Past Accepting new patients
Southeastern Vascular, P.C. Vascular Surgery Past Accepting new patients
Hawthorn Medical Associates, LLC Past Accepting new patients

Organizations & group practices 6

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1336179191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CAMP ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013063",
            "telephone_number": "508-775-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMP ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013063",
            "telephone_number": "508-775-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "ROGER",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MA",
            "license": "53027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "230000567",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "29059",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS MEDICARE PREFERRED",
            "identifier": "722914",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "17-01032",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6177735",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J03236",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

Verify at the official NPI Registry.