Active NPI
Eric Rosenberg, MD
- Internal Medicine Physician
- West Hartford, CT
National Provider Identifier
1417960337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 026519
- Practice address
- 631 Quaker LN S
West Hartford, CT 06110-1026 - Phone
- (860) 233-5133
- Fax
- (860) 233-5212
- NPI assigned
- Aug 14, 2006
- Last updated
- Jul 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 026519 | CT | Primary |
Addresses
Primary practice location
631 Quaker LN S
West Hartford, CT 06110-1026
Mailing address
4 Farm Springs Rd
Prohealth Physicians
Farmington, CT 06032-2573
Phone (860) 284-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091222000400 | CT | Practitioner - Internal Medicine | 4688714702 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026519 | CT | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1417960337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 FARM SPRINGS RD",
"address_2": "PROHEALTH PHYSICIANS",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060322573",
"telephone_number": "860-284-5200",
"fax_number": "860-284-5333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 QUAKER LN S",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061101026",
"telephone_number": "860-233-5133",
"fax_number": "860-233-5212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBERG",
"first_name": "ERIC",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "026519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.