Active NPI
Neal Rosenberg III, D.D.S
- Dentist
- Cedarburg, WI
National Provider Identifier
1447659644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1000990-015
- Practice address
- N57W6296 Center St
Cedarburg, WI 53012-1906 - Phone
- (262) 377-5130
- NPI assigned
- Aug 14, 2014
- Last updated
- Oct 26, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1000990-15 | WI | |
| Dentist | 122300000X | 1000990-015 | WI | Primary |
Addresses
Primary practice location
N57W6296 Center St
Cedarburg, WI 53012-1906
Mailing address
746 Lakefield Rd
Grafton, WI 53024-9722
Phone (262) 707-2931
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160108001887 | WI | Order and Referring Only - Dentist | 6305148271 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1000990-015 | WI | MD | Dentist |
| 1000990-15 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahp 005 LLC | Current | Accepting new patients |
Locations
N57W6296 Center St
Cedarburg, WI 53012
Phone (262) 377-5130
Interoperability endpoints
- nrosenberg364201@direct.ochin.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698278400000",
"number": "1447659644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "746 LAKEFIELD RD",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530249722",
"telephone_number": "262-707-2931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N57W6296 CENTER ST",
"city": "CEDARBURG",
"state": "WI",
"postal_code": "530121906",
"telephone_number": "262-377-5130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBERG",
"first_name": "NEAL",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-14",
"last_updated": "2023-10-26",
"certification_date": "2023-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "1000990-15",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "1000990-015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cedarburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.