Individual provider Active NPI

Jeffrey L Rosenberg, M.D.

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1407906456
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G43325 Issued in CA
Practice address
1245 Wilshire BL.
Suite 601
Los Angeles, CA 90017-4806
Phone
(213) 977-0257
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G43325 CA Primary

Addresses

Primary practice location

1245 Wilshire BL.
Suite 601
Los Angeles, CA 90017-4806

Mailing address

1245 Wilshire BL. #601
Los Angeles, CA 90017-4806
Phone (213) 977-0257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120409000554 CA Practitioner - Plastic and Reconstructive Surgery 0143481705 Practice locations: Los Angeles, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43325CAMDGeneral Practice Dentistry
G43325CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Keagle Medical, Inc. Past Accepting new patients
Anita Patel, M.D., Inc. Past Accepting new patients

Organizations & group practices 2

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407906456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BL. #601",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174806",
            "telephone_number": "213-977-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BL.",
            "address_2": "SUITE 601",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174806",
            "telephone_number": "213-977-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G43325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.