NPIMap

Organization Active NPI

Prudencio G Rosas MD PA

  • Family Medicine Physician
  • Seaford, DE
National Provider Identifier
1467541136
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C10000903 Issued in DE
Legal business name
PRUDENCIO G ROSAS MD PA
Practice address
908 Middleford Rd
Seaford, DE 19973-3604
Phone
(302) 629-9592
Fax
(302) 629-7573
NPI assigned
Oct 12, 2006
Last updated
Dec 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Authorized official

Name
Prudencio G Rosas, M.D.
Title
Physician
Phone
(302) 629-9592

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X C10000903 DE Primary

Addresses

Primary practice location

908 Middleford Rd
Seaford, DE 19973-3604

Mailing address

908 Middleford Rd
Seaford, DE 19973-3604
Phone (302) 629-9592

National Provider Directory

National Provider Directory

Locations

908 Middleford Rd
Seaford, DE 19973
Phone (302) 629-9592

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1467541136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733604",
            "telephone_number": "302-629-9592",
            "fax_number": "302-629-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733604",
            "telephone_number": "302-629-9592",
            "fax_number": "302-629-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENCIO G ROSAS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "ROSAS",
        "authorized_official_first_name": "PRUDENCIO",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "302-629-9592",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C10000903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaford, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.