Individual provider Active NPI

Rosemary De Angelis Laird, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Viera, FL
National Provider Identifier
1407856131
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME85100 Issued in FL
Practice address
7000 Spyglass CT Ste 501
Viera, FL 32940-8288
Phone
(321) 247-7063
Fax
(866) 422-6264
NPI assigned
Jul 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME85100 FL Primary

Addresses

Primary practice location

7000 Spyglass CT Ste 501
Viera, FL 32940-8288

Mailing address

7000 Spyglass CT Ste 501S
Viera, FL 32940-8288
Phone (321) 247-7063

Other identifiers 2

IdentifierTypeStateIssuer
5X271OtherFLORIDA BLUE
1563738OtherCIGNA

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101101001241 FL Practitioner - Geriatric Medicine 8527094259 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Georgetown University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Memory Care LLCGroup PAC ID 5193107936, 2 clinicians

Practice addresses (Care Compare)

Viera, FL 32940
Phone (321) 247-7063

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME85100FLMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince May 4, 2015 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince May 4, 2015 Accepting new patients
My Memory Care LLC Geriatric Medicine CurrentSince Jan 15, 2022 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

7000 Spyglass Ct
Ste 501
Viera, FL 32940
Phone (321) 247-7063

1933 Dundee Dr
Winter Park, FL 32792
Phone (407) 622-2647

Organizations & group practices 3

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 2

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1407856131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 SPYGLASS CT STE 501S",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329408288",
            "telephone_number": "321-247-7063",
            "fax_number": "866-422-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 SPYGLASS CT STE 501",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329408288",
            "telephone_number": "321-247-7063",
            "fax_number": "866-422-6264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIRD",
        "first_name": "ROSEMARY",
        "middle_name": "DE ANGELIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME85100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "5X271",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1563738",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Viera, FL

Sources for this page

Verify at the official NPI Registry.