Stefanie M. Rosenberg, P.A.
Individual provider Active NPI Medical Physician Assistant · Bayside, WI
NPI 1366435083 · NPPES record last updated Sep 10, 2024
Key facts
- NPI
- 1366435083
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 2521-023 (WI)
- Practice address
- 500 W Brown Deer Rd
Bayside, WI 53217-1627 - Phone
- (414) 434-0461
- Fax
- (414) 434-0467
- NPI assigned
- Aug 29, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Froedtert South Inc
Practice addresses (Care Compare)
6308 8TH Ave
Kenosha, WI 53143-5031
Phone (262) 771-0073
9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8300
Hospital & facility affiliations
- Froedtert South Inc.
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.26 of 100
- Quality
- 84.3
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100203000723 | WI | Practitioner - Physician Assistant | 2264457423 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63921 | CA | MD | Dentist |
| 2521-023 | WI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current |
Accepting new patients | |
| Froedtert South, Inc. | Current |
Accepting new patients | |
| Providence Medical Foundation | Current |
Accepting new patients | |
| Providence Medical Foundation | Past | Accepting new patients | |
| Endeavor Health Medical Group | Past | Accepting new patients | |
| Endeavor Health Medical Group | Past | Accepting new patients |
Locations
200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841
2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229
500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842
1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210
6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300
9555 76th St
Ste 3880
Pleasant Prairie, WI 53158
Phone (263) 653-5483
Interoperability endpoints
- srosenberg861152@direct.froedtert.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 63921 | CA | |
| Medical Physician Assistant | 363AM0700X | 2521-023 | WI | Yes |
Addresses
Primary practice location
500 W Brown Deer Rd
Bayside, WI 53217-1627
Mailing address
500 W Brown Deer Rd
Bayside, WI 53217-1627
Phone (414) 434-0461
Other practice location 1
2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 269-4253
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | STEFANIE.ROSENBERG@hca6.eclinicaldirectplus.com |
Other providers in Bayside, WI
- Maggie Vita Poklar
- Rehab Medical Supplies,Inc
- Jill Marie Repinski
- Noah James Ripley
- Johanna Rolf
- Janay Sellers
- Jennifer L Sharpe
- Michelle Silverman
- Sport Clinic Physical Therapy Inc
- Sports Physical Therapy & Rehab Specialist, S.C.
All providers in Bayside, WI · Medical Physician Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.