Individual provider Active NPI

Carly Rosen, MD

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1376120881
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
327609 Issued in NY
Practice address
250 W 57TH St FL 15
New York, NY 10107-1307
Phone
(212) 523-4000
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 327609 NY Primary

Addresses

Primary practice location

250 W 57TH St FL 15
New York, NY 10107-1307

Mailing address

250 W 57TH St FL 15
New York, NY 10107-1307
Phone (212) 523-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240621002163 NY Practitioner - Emergency Medicine 6800339532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Maryland School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

375 Seguine Ave
Staten Island, NY 10309-3932
Phone (718) 226-6902

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
327609NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince May 28, 2024 Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: crosen24542@northwell.direct-ci.com

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 and National Provider Directory roles.

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1376120881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 57TH ST FL 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101071307",
            "telephone_number": "212-523-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W 57TH ST FL 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101071307",
            "telephone_number": "212-523-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "CARLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "327609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.