Edward Esther Rosenquist, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

837-023 Issued in WI

Practice address

1200 Oakleaf Way
Suite a
Altoona, WI 54720-2245

Phone

(715) 832-1400

Fax

(715) 832-4187

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1437191772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 OAKLEAF WAY",
            "address_2": "SUITE A",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547202245",
            "telephone_number": "715-832-1400",
            "fax_number": "715-832-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OAKLEAF WAY",
            "address_2": "SUITE A",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547202245",
            "telephone_number": "715-832-1400",
            "fax_number": "715-832-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENQUIST",
        "first_name": "EDWARD",
        "middle_name": "ESTHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "837-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42956400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH PLAN",
            "identifier": "44909",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA/SELECTCARE CF",
            "identifier": "01 14471",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2400797",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA/SELECTCARE EC",
            "identifier": "01 14469",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00171102",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nhharris@cvosm.gwaydirect.com",
            "affiliation": "N",
            "address_1": "1200 OakLeaf Way",
            "address_2": "Suite A",
            "city": "Altoona",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547202245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Altoona, WI
• Providers in Altoona, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.