Individual provider Active NPI

Danielle Rose, PA-C

  • Medical Physician Assistant
  • Flint, MI
National Provider Identifier
1417474917
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
5020 W Bristol Rd
Flint, MI 48507-2919
Phone
(810) 732-1620
NPI assigned
Aug 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

5020 W Bristol Rd
Flint, MI 48507-2919

Mailing address

34447 Fargo St
Livonia, MI 48152-1469
Phone (734) 560-7774

Other names 1

  • Danielle Kobrossi Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171010001539 MI Practitioner - Physician Assistant 7416222922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular Surgery Assoc PCGroup PAC ID 2567443559, 16 clinicians

Practice addresses (Care Compare)

1122 S Lapeer Rd C
Lapeer, MI 48446-3387
Phone (810) 272-3880

4700 McLeod E Dr a
Saginaw, MI 48604-2826
Phone (989) 921-0900

5020 W Bristol Rd
Flint, MI 48507-2919
Phone (810) 732-1620

5054 W Bristol Rd
Suite E
Flint, MI 48507-2952
Phone (810) 600-2030

5202 Miller Rd
Flint, MI 48507-1040
Phone (810) 600-0560

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Surgery Assoc, PC Past Accepting new patients
Vascular Surgery Assoc, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: daniellerose@mvc.allscriptsdirect.net

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 1

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": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1417474917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34447 FARGO ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521469",
            "telephone_number": "734-560-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072919",
            "telephone_number": "810-732-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "KOBROSSI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.