NPIMap

Individual provider Active NPI

Lynne N Rosen, M.D

  • Pediatrics Physician
  • Oakland, CA
National Provider Identifier
1366760175
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A111157 Issued in CA
Practice address
3451 East 12TH St.
Oakland, CA 94601-3425
Phone
(510) 535-3600
Fax
(510) 535-4247
NPI assigned
May 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A111157 CA Primary

Addresses

Primary practice location

3451 East 12TH St.
Oakland, CA 94601-3425

Mailing address

P.O. Box 22210
Oakland, CA 94623-2210
Phone (510) 535-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190124002726 CA Practitioner - Pediatric Medicine 1254574007 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc CurrentSince Nov 1, 2018 Accepting new patients
La Clinica de la Raza Inc CurrentSince Nov 1, 2018 Accepting new patients
La Clinica de la Raza Inc Current Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Children'S Hospital & Research Center at Oakland Past Accepting new patients
La Clinica de la Raza, Inc. Past Accepting new patients

Locations

3451 E 12th St
Fl 2
Oakland, CA 94601
Phone (510) 535-3319

3451 E 12th St
Oakland, CA 94601
Phone (510) 535-3319

Interoperability endpoints

  • Direct secure messaging: lrosen306728@direct.ochin.org

Organizations & group practices 7

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": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1366760175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 22210",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946232210",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 EAST 12TH ST.",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013425",
            "telephone_number": "510-535-3600",
            "fax_number": "510-535-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "LYNNE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-04",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A111157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.