Individual provider Active NPI

Andrew Alexander Rosenberg

  • Emergency Medicine Physician
  • Detroit, MI
National Provider Identifier
1417334590
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301108316 Issued in MI
Practice address
4201 Saint Antoine St
6G Uhc
Detroit, MI 48201
Phone
(313) 993-2529
NPI assigned
Apr 28, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301108316 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4201 Saint Antoine St
6G Uhc
Detroit, MI 48201

Mailing address

741 Suffield Ave
Birmingham, MI 48009-1257
Phone (248) 730-0516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180714000143 MI Practitioner - Emergency Medicine 2163711623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center Emergency ServicesGroup PAC ID 0648182071, 30 clinicians

Practice addresses (Care Compare)

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3000

Hospital & facility affiliations

  • Harper University Hospital Hospital, Detroit, MI, CCN 230104
  • Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301108316MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Emergency Services CurrentSince Jun 9, 2018 Accepting new patients

Locations

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

4201 Saint Antoine St
#6G
Detroit, MI 48201
Phone (313) 993-2529

4201 Saint Antoine St
Ste 3R
Detroit, MI 48201
Phone (313) 745-3330

Interoperability endpoints

  • Direct secure messaging: arosenbe@direct.dmc.org

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 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": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1417334590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 SUFFIELD AVE",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480091257",
            "telephone_number": "248-730-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "6G UHC",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-993-2529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "ANDREW",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-28",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301108316",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.