Organization Active NPI

Marc a Rosenblatt MD LLC

  • Specialist
  • Jackson Heights, NY
National Provider Identifier
1417129529
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
154949 Issued in NY
Legal business name
MARC A ROSENBLATT MD LLC
Practice address
3747 77TH St
Jackson Heights, NY 11372-6629
Phone
(718) 505-0960
NPI assigned
Mar 28, 2008
Last updated
Mar 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Authorized official

Name
Marc A Rosenblatt, MDNPI 1952392466
Title
Director
Phone
(212) 472-8546

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 154949 NY Primary

Addresses

Primary practice location

3747 77TH St
Jackson Heights, NY 11372-6629

Mailing address

114 E 72ND St
1D
New York, NY 10021-4245
Phone (212) 472-8546

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040713000099 NY Part B Supplier - Clinic/Group Practice 1951205954 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Jackson Heights, NY; New York, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Marc a Rosenblatt MD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3747 77th St
Jackson Hts, NY 11372
Phone (718) 505-0960

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1417129529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E 72ND ST",
            "address_2": "1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214245",
            "telephone_number": "212-472-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3747 77TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726629",
            "telephone_number": "718-505-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC A ROSENBLATT MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "ROSENBLATT",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "212-472-8546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "154949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.