Individual provider Active NPI

Lisa Rosen

  • Clinical Social Worker
  • Boynton Beach, FL
National Provider Identifier
1386123339
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW15051 Issued in FL
Practice address
10863 Lake Wynds CT
Boynton Beach, FL 33437-3238
Phone
(347) 239-5703
NPI assigned
Aug 10, 2018
Last updated
Aug 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW15051 FL Primary

Addresses

Primary practice location

10863 Lake Wynds CT
Boynton Beach, FL 33437-3238

Mailing address

10863 Lake Wynds CT
Boynton Beach, FL 33437-3238
Phone (347) 239-5703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190129001542 FL Practitioner - Clinical Social Worker 5395082341 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1386123339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10863 LAKE WYNDS CT",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373238",
            "telephone_number": "347-239-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10863 LAKE WYNDS CT",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373238",
            "telephone_number": "347-239-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW15051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.