Organization Active NPI

Michael Eric Rosen, MD, PC

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1386847986
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
225604 Issued in NY
Legal business name
MICHAEL ERIC ROSEN, MD, PC
Practice address
425 W 59TH St
4A
New York, NY 10019-1104
Phone
(212) 489-8800
Fax
(212) 977-9111
NPI assigned
Jun 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Authorized official

Name
Dr. Michael Eric Rosen, MDNPI 1114910890
Title
Head of Corporation
Phone
(212) 489-8800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 225604 NY Primary

Addresses

Primary practice location

425 W 59TH St
4A
New York, NY 10019-1104

Mailing address

230 E 79TH St Apt 18F
New York, NY 10021-1256
Phone (212) 988-2305

Other identifiers 1

IdentifierTypeStateIssuer
02461989MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070702000324 NY Part B Supplier - Clinic/Group Practice 1557460649 Receives reassigned benefits from 1 practitioner
Practice locations: Briarcliff Manor, NY; New York, NY

National Provider Directory

National Provider Directory

Locations

581 Old White Plains Rd
Tarrytown, NY 10591
Phone (914) 297-8594

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1386847986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E 79TH ST APT 18F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100211256",
            "telephone_number": "212-988-2305",
            "fax_number": "212-977-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 59TH ST",
            "address_2": "4A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191104",
            "telephone_number": "212-489-8800",
            "fax_number": "212-977-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL ERIC ROSEN, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-09",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "HEAD OF CORPORATION",
        "authorized_official_telephone_number": "212-489-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "225604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02461989",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.